Digestive Diseases and Sciences

, Volume 47, Issue 5, pp 954–958 | Cite as

Effect of Esomeprazole 40 mg vs Omeprazole 40 mg on 24-Hour Intragastric pH in Patients with Symptoms of Gastroesophageal Reflux Disease

  • Kerstin Röhss
  • Göran Hasselgren
  • Hans Hedenström


Maintenance of intragastric pH > 4 is vital for effective management of gastroesophageal reflux disease (GERD). Esomeprazole 40 mg, the first proton pump inhibitor developed as an optical isomer, demonstrates improved acid inhibition over omeprazole 20 mg. Our aim was to compare esomeprazole 40 mg with omeprazole 40 mg, once-daily, on intragastric acidity in patients with symptoms of GERD. In this open-label, crossover study, 130 patients with symptoms of GERD received esomeprazole 40 mg or omeprazole 40 mg once-daily for five days. The 24-hr intragastric pH was monitored on days 1 and 5 of each treatment period. The mean percentage of the 24-hr period with intragastric pH > 4 was significantly greater (P < 0.001) with esomeprazole 40 mg than with omeprazole 40 mg on days 1 (48.6% vs 40.6%) and 5 (68.4% vs 62.0%). Interpatient variability was significantly less with esomeprazole than omeprazole. Esomeprazole was well tolerated. In conclusion, esomeprazole 40 mg provides more effective acid control than twice the standard dose of omeprazole.

esomeprazole omeprazole gastroesophageal reflux disease intragastric pH pharmacodynamics 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Bell NJV, Burget D, Howden CW, Wilkinson J, Hunt RH: Appropriate acid suppression for the management of gastroesophageal reflux disease. Digestion 51(suppl 1):59–67, 1992Google Scholar
  2. 2.
    Fiorucci S, Santucci L, Chiucchiu S, Morelli A: Gastric acidity and gastroesophageal reflux patterns in patients with esophagitis. Gastroenterology 103:855–861, 1992Google Scholar
  3. 3.
    Spencer J: Prolonged pH recording in the study of gastroesophageal reflux. Br J Surg 56:912–914, 1989Google Scholar
  4. 4.
    Johnson LF, DeMeester TR: Development of the 24-hour intraesophageal pH monitoring composite scoring system. J Clin Gastroenterol 8(suppl 1):52–58, 1986Google Scholar
  5. 5.
    DeVault KR, Castell DO: The Practice Parameters Committee of the American College of Gastroenterology. Updated guidelines for the diagnosis and treatment of gastroesophageal reflux disease. Am J Gastroenterol 94:1434–1442, 1999Google Scholar
  6. 6.
    Dent J, Brun J, Fendrick AM, Fennerty MB, Janssens J, Kahrilas PJ, Lauristen K, Reynold JC, Shaw M, Talley NJ: An evidence-based appraisal of reflux disease management--the Genval Workshop Report. Gut 44(suppl 2):S1–S16, 1999Google Scholar
  7. 7.
    Chiba N, De Gara CJ, Wilkinson JM, Hunt RH: Speed of healing and symptom relief in grade II to IV gastroesophageal reflux disease: A meta-analysis. Gastroenterology 112:1798–1810, 1997Google Scholar
  8. 8.
    Hatlebakk JG, Hyggen A, Madsen PH, Walle PO, Schultz T, Mowinckel P: Heartburn treatment in primary care: Randomized, double-blind study for 8 weeks. BMJ 319:550–553, 1999Google Scholar
  9. 9.
    Crawley JA, Schmitt CM: How satisfied are chronic heartburn sufferers with their prescription medications? Results of the Patient Unmet Needs Survey. J Clin Outcomes Manage 7:29–34, 2000Google Scholar
  10. 10.
    Lind T, Rydberg L, Kylebäck A, Jonsson A, Andersson T, Hasselgren G, Holmberg J. Röhss K: Esomeprazole provides improved acid control versus omeprazole in patients with gastroesophageal reflux disease. Aliment Pharmacol Ther 14:861–867, 2000Google Scholar
  11. 11.
    Röhss K, Claar-Nilsson C, Rydholm H, Nyman L: Esomeprazole 40 mg provides more effective acid control than lansoprazole 30 mg. Gastroenterology 118(suppl 2):A22, 2000Google Scholar
  12. 12.
    Wilder-Smith C, Röhss K, Lundin C, Rydholm H: Esomeprazole 40 mg provides more effective acid control than pantoprazole 40 mg. Gastroenterology 118(suppl 2):A20, 2000Google Scholar
  13. 13.
    Wilder-Smith C, Röhss K, Claar-Nilsson C, Rydholm H: Esomeprazole 40 mg provides more effective acid control than rabeprazole 20 mg. Gut 47(suppl 3):A63, 2000Google Scholar
  14. 14.
    Kahrilas PJ, Falk GW, Johnson DA, Schmitt C, Collins DW, Whipple J, D' Amico D, Hamelin B, Joelsson B, for the Esomeprazole Study Investigators: Esomeprazole improves healing and symptom resolution as compared with omeprazole in reflux oesophagitis patients: a randomized controlled trial. Aliment Pharmacol Ther 14:1249–1258, 2000Google Scholar
  15. 15.
    Richter JE, Kahrilas PJ, Johanson J, Maton P, Breiter J, Hwang C, Marino V, Hamlin B, Levine J, for the Esomeprazole Study Investigators: Efficacy and safety of esomeprazole compared with omeprazole in GERD patients with erosive esophagitis: A randomized controlled trial. Am J Gastroenterol 96:656–665, 2001Google Scholar
  16. 16.
    Snedecor GW, Cochran WG: Statistical Methods. Ames, The Iowa State University Press, 1967, 197 ppGoogle Scholar
  17. 17.
    Joelsson B, Johnsson F: Heartburn--the acid test. Gut 30:1523–1525, 1989Google Scholar
  18. 18.
    Masclee AAM, De Best ACAM, De Graaf R, Cluysenaer OJJ, Jansen JBMJ: Ambulatory 24-hour pH-metry in the diagnosis of gastresophageal reflux disease. Scand J Gastroenterol 25:225–230, 1990Google Scholar
  19. 19.
    Maton PN, Vakil NB, Levine JG, Hwang C, Skammer W, Lundborg P: Safety and efficacy of long term esomeprazole therapy in patients with healed erosive oesophagitis. Drug Safety 24:625–635, 2001Google Scholar

Copyright information

© Plenum Publishing Corporation 2002

Authors and Affiliations

  • Kerstin Röhss
    • 1
  • Göran Hasselgren
    • 1
  • Hans Hedenström
    • 2
  1. 1.AstraZeneca R&D MölndalMölndalSweden
  2. 2.Department of Medical Sciences, Clinical PhysiologyUniversity HospitalUppsalaSweden

Personalised recommendations