Lansoprazole Compared With Ranitidine for the Treatment of Nonerosive Gastroesophageal Reflux Disease

Richter, Joel E.; Campbell, Donald R.; Kahrilas, Peter J.; Huang, Bidan; Fludas, Cheryl

doi:10.1001/archinte.160.12.1803

Cited by 130 publications

(84 citation statements)

References 26 publications

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“…Bile reflux is more sever in patients with long segment Barrett's oesophagus and aggressive acid suppression therapy reduces both acid and bile reflux. It is unclear why bile reflux should reduce in response to PPIs but Richter et al (2000) suggest that this is related to the reduced volume of acid in the stomach and so reducing the volume available for reflux into the esophagus. Incomplete acid suppression allows oesophageal exposure to bile acids to continue and may potentiate the ability of bile acids to cause damage, this may be a risk factor for adenocarcinoma.…”

Section: Role Of Medication In the Control Of Dgermentioning

confidence: 99%

Review Article; Duodeno-Gastro-Esophageal Reflux Combined and Isolated

Nasr¹

2013

American Medical Journal

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Barrett's esophagus is the chief risk factor for esophageal adenocarcinoma. Reflux of gastric acid has long been related to the development of esophagitis and Barrett's esophagus, but the role of duodenal contents is controversial. We review the literature on the role of duodenal contents in the development of esophagitis, Barrett's esophagus and adenocarcinoma in addition to the role of acid suppressant therapy in the development or prevention of these changes. A computer-based search of the literature using the terms "Bilirubin, Barrett, Bile Reflux, duodeno-gastric reflux and oesophagus/esophagus" was performed. The role of bile and other constituents of duodenal refluxate were examined. Techniques for identifying nonacid reflux were also reviewed, as were the role of pH, medication and surgery in modulating disease severity. Complicated Barrett's esophagus is associated with increased exposure to gastric and duodenal refluxate. Biological effect of bile acids depends on the conjugation status, the pH of the milieu and the pKa of bile acids. While Proton Pump Inhibitors reduce the levels of DGER, they also produce changes in gastric and lower esophageal pH that activate different bile acids at different pH levels resulting in unexpected injury. Conjugated bile acids are harmful in acidic environment while unconjugated bile acids are harmful at neutral pH environment. An overlap of toxicity among conjugated and unconjugated bile acids occurs between strongly acidic and neutral pH levels. Normalisation of gastric and duodenal refluxate should ideally be the goal of treatment.

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Section: Role Of Medication In the Control Of Dgermentioning

confidence: 99%

Review Article; Duodeno-Gastro-Esophageal Reflux Combined and Isolated

Nasr¹

2013

American Medical Journal

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“…Over-the-counter H 2 RA preparations may not be suitable as universal therapies; studies have suggested that complete symptom relief may occur in as few as 15% of patients [26]. The most common adverse events include headache, dizziness, diarrhea, fatigue and confusion [21].…”

Section: Histamine-receptor Antagonistsmentioning

confidence: 99%

“…In nonerosive esophagitis, effects on daytime heartburn were similar with lansoprazole 15 and 30 mg, while the 15-mg dose was more effective against nighttime symptoms [39]. A numerical advantage of lansoprazole 15 mg over 30 mg was shown in a study looking at both daytime and nighttime heartburn [26]. For this reason, the use of lansoprazole 15 mg was tested for the treatment of frequent heartburn in an OTC setting.…”

Section: Lansoprazole In the Treatment Of Acid-related Gastrointestinmentioning

confidence: 99%

Knowledge and Usage Patterns of Folic Acid amongst Physician Assistant Students at the University of Texas Medical Branch at Galveston.

West¹,

Acosta

Reynado

et al. 2010

IJAPA

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Purpose: Heartburn is a common symptom among adults, and can be troublesome when experienced more than two times a week. Heartburn and regurgitation are characteristic symptoms of gastroesophageal reflux disease, and may be experienced alone or in combination with other symptoms of reflux. The nurse practitioner should be aware of recent developments in the management of frequent heartburn that may be relevant to patients with this condition. Therefore the present review discusses the current treatment options for frequent heartburn with a focus on lansoprazole 15 mg, a recently approved over-the-counter proton pump inhibitor for frequent heartburn. Methods: The role of lansoprazole in the treatment of gastroesophageal reflux disease and heartburn was assessed using an online database search using PubMed, supplemented by the author's knowledge of the management of the disease.Conclusions: The management of frequent heartburn is an important issue for nurse practitioners. Available pharmacologic treatments include antacids, histamine 2 -receptor antagonists, and proton pump inhibitors. The latter are the agents of choice for treatment as they have been available by prescription for many years. These agents have proven efficacy and excellent safety and tolerability profiles. Lansoprazole has recently been approved for over-the-counter sale for the short-term (14 days) treatment of frequent heartburn.Implications for practice: Nurse practitioners should be aware of the evidence to support the change in status of lansoprazole from prescription to over-the-counter, in order to appropriately advise their patients.

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“…In the meta-analysis of 6 randomized trials in which H2RA and placebo were compared, the incidence of all of the adverse effects was similar among the arms (RR: 1.13, 95% CI: 0.97-1.31) (39)(40)(41)(42)(43)(44). In the meta-analysis of 8 randomized trials that compared PPI and H2RA, no difference was found between the two groups of drugs in terms of all of the adverse effects (RR: 0.94, 95% CI: 0.86-1.02) and serious adverse effects (RR: 0.93, 95% CI: 0.85-1.01) (39,(45)(46)(47)(48)(49)(50)(51).…”

mentioning

confidence: 98%

“…In the meta-analysis of 17 randomized controlled trials in which reflux patients were included and PPI was compared with the arms of surgery or placebo, no difference was observed in terms of all of the adverse effects (RR: 1.04, 95% CI: 0.98-1.11) (23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39). In the meta-analysis of 6 randomized trials in which H2RA and placebo were compared, the incidence of all of the adverse effects was similar among the arms (RR: 1.13, 95% CI: 0.97-1.31) (39)(40)(41)(42)(43)(44).…”

mentioning

confidence: 99%

What is the long term acid inhibitor treatment in gastroesophageal reflux disease? What are the potential problems related to long term acid inhibitor treatment in gastroesophageal reflux disease? How should these cases be followed?

Hatemı

Esatoğlu

2017

Turk J Gastroenterol

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Decreased acid secretion is thought to adversely affect the absorption of calcium and increase the risk of fracture by causing a decrease in bone density. The meta-analyses of observational studies conducted with heterogeneous populations showed that the risk of any fracture (OR: 1.29, 95% CI: 1.18-1.41) and hip fracture (OR: 1.23, 95% CI: 1.11-1.36) slightly increased with PPI depending on the dose and regardless of duration; but no risk increase was detected with H2RA use (1,2).There are meta-analyses with different methodologies reporting that high gastric pH values developing due to acid inhibition increases Clostridium difficile infections by altering the intestinal microflora and in observational studies conducted with different patient populations. This risk has been reported to be higher in PPI treatment (OR: 2.15, 95% CI: 1.81-2.55) compared to H2RA (OR: 1.44, 95% CI: 1.22-1.70) (3,4).It was reported in the meta-analysis published in 2013 that bacterial overgrowth increased with the use of PPI (OR: 2.26, 95% CI: 1.24-4.2) (5). Spontaneous bacterial peritonitis that develops due to the translocation of enteric pathogens is a significant cause of mortality for cirrhotic patients. The hypothesis that the risk of spontaneous bacterial peritonitis may increase due to easy proliferation of intestinal bacteria with decreased stomach acid has been confirmed in the meta-analysis of observational studies in which the relationship with PPI was investigated (OR: 3.15, 95% CI: 2.09-4.74). On the Turk J Gastroenterol 2017; 28(Suppl 1): S57-S60What is the long term acid inhibitor treatment in gastroesophageal reflux disease? What are the potential problems related to long term acid inhibitor treatment in gastroesophageal reflux disease? How should these cases be followed? S57 ABSTRACTThe meta-analyses of observational studies (OBS) showed the risk of any fracture and hip fracture slightly increased with proton pump inhibitor (PPI) treatment depending on the dose and regardless of time. This was not observed with histamine-2 receptor antagonists (H2RA). The risk of bacterial overgrowth and spontaneous bacterial peritonitis were increased with PPI therapy, but not with H2RA. In meta-analyses of OBS, a slight increase was observed in the risk of community-acquired pneumonia (CAP) in the early stages (<1 month) of PPI use and particularly at high doses. In a five-year LOTUS study, no difference was found in vitamin B12, folic acid, vitamin D, and calcium values in terms of the initial and end of follow-up levels. No increase in the risk of premalignant gastric lesions was observed in the meta-analysis of RCTs in which PPI treatment (≥6 months) was given to Helicobacter pylori negative patients. The risk of hypomagnesemia with PPI use was increased in patients having GFR<60, using diuretics, and over 65 years of age. Quasi-experimental studies showed a reduced zinc absorption with PPI use. In the meta-analysis of OBS, long-term (>1 year) PPI use increased the risk of fundic polyps, but no risk was found in shorter use. Th...

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Lansoprazole Compared With Ranitidine for the Treatment of Nonerosive Gastroesophageal Reflux Disease

Abstract: Lansoprazole therapy is more effective than standard dosages of ranitidine or placebo in relieving symptoms in patients with endoscopically confirmed non-erosive reflux esophagitis.

Cited by 130 publications

References 26 publications

Review Article; Duodeno-Gastro-Esophageal Reflux Combined and Isolated

Review Article; Duodeno-Gastro-Esophageal Reflux Combined and Isolated

Knowledge and Usage Patterns of Folic Acid amongst Physician Assistant Students at the University of Texas Medical Branch at Galveston.

What is the long term acid inhibitor treatment in gastroesophageal reflux disease? What are the potential problems related to long term acid inhibitor treatment in gastroesophageal reflux disease? How should these cases be followed?

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