Abstract
Purpose
The purpose of this study was to compare the efficacy of proton pump inhibitor (PPI) with H2 receptor antagonist (H2RA) in treatment of upper abdominal symptoms.
Methods
This was a multi-center, open study conducted at 102 hospitals in Japan. Patients with reflux esophagitis received famotidine 10 mg twice daily for 2 weeks, then omeprazole 10 mg once daily for 2 weeks. Thereafter, patients were switched to famotidine 10 mg twice daily for a third 2-weekperiod, provided those with a medical condition agreed to continue the study. Patients evaluated the treatment response to each gastrointestinal symptom using a predefined patient questionnaire and gastrointestinal symptom rating scale (GSRS).
Results
161 patients entered the study, of whom 8 were excluded from all analyses due to lack of participation following entry. Overall symptom improvement rate (n = 130) at week 4, after the 2-week omeprazole treatment, was 75.4% and this was significantly higher than that after the first 2-week famotidine treatment (41.5%) at week 2. In patients (n = 36) who completed 6 weeks of treatment, 2-week omeprazole treatment at week 4 showed a significantly higher overall symptom improvement rate compared with both the first 2-week and third 2-week famotidine treatments.
Conclusions
Omeprazole was superior to famotidine for treatment of upper abdominal symptoms in patients with reflux esophagitis, which suggested that gastric acid might be a cause not only of reflux symptoms, but also of ulcer symptoms and dysmotility symptoms such as epigastric pain and feeling of fullness in reflux esophagitis.
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Acknowledgments
There was no financial support for the study. We would like to thank the following investigators: Iwakiri R, Sakata H, Tsunada S, Ootani H, Sakata Y, Fujise T, Shimoda R, Shiraishi R, Watanabe K, Akiyama T, Saga Medical School; Okada K, Fujiyamato Onsen Hospital; Nakayama S, Kanzaki Clinic; Matsunaga C, Matsunaga Medical Clinic; Matsunaga K, Arima S, Sasebo Kyosai Hospital; Ogata S, Nakahara S, Mannen K, Saga Prefectural Hospital Koseikan; Kikkawa A, Takeo City Hospital; Tsuruta H, Kawazoe H, National Hospital Organization Ureshino Medical Center; Fujioka Y, Yamaguchi K, Fujioka Hospital; Sakata Y, Yuaikai Oda Hospital; Ishibashi S, Koga Pediatric Medical Hospital; Fujisaki J, Fujisaki Clinic; Mori H, Mori Clinic; Mitsuoka S, Mitsuoka Medical Gastrointestinal Clinic; Maeyama H, Maeyama Medical Gastrointestinal Clinic; Danjo A, Oyama T, Saga Social Insurance Hospital; Noda T, Matsumoto Y, Karatsu Red Cross Hospital; Endo H, Kojima M, Saiseikai Karatsu Hospital; Fukuyama K, Karatsu City Hospital Kitahata; Tomonaga M, Tomonaga Clinic; Tanaka T, Tanaka Medical Clinic; Fujimura T, Yamaguchi Hospital; Ono T, Ono Clinic; Tsuchihashi K, Tsuchihashi Clinic; Terada H, Terada Medical Clinic; Inutsuka S, Inutsuka Hospital; Kuwahara A, Omachi Municipal Hospital; Muto Y, Muto Medical Clinic; Moriyama M, Moriyama Medical Gastrointestinal Clinic; Sakata T, Sakata Clinic; Goto S, Amemori S, Taku City Hospital. Sakagami T, Nakajima K, Yamamoto N, Ohshima T, Hyogo College of Medicine; Yamamura M, Kobe Ekisaikai Hospital; Toyoda T, Nomura Kaihin Hospital; Arai E, Nishinomiya Kyoritsu Neurosurgical Hospital; Sawada Y, Takarazuka Municipal Hospital; Hayashi T, Amagasaki Central Hospital; Kishi K, Meiwa Hospital; Yamaji S, Seiwa Hospital; Hara H, Hara Surgery Clinic; Kuroda Y, Kuroda Clinic; Kishimoto Y, Kishimoto Clinic; Kang K, Asahi Clinic; Yamamoto I, Yamamoto Clinic; Akashi H, Akashi Clinic; Takahashi A, Tsukumo Memorial Hospital. Furuta K, Amano Y, Ishihara S, Sato S, Shimane University School of Medicine; Amano K, Masuda Red Cross Hospital; Okuyama T, Kurashiki Medical Center; Matsumori Y, Takatsuki General Hospital; Higashi R, Shibagaki K, Tottori Municipal Hospital; Niigaki M, Shimane Adult Disease Prevention Center; Hamamoto N, Unnan Municipal General Hospital; Mishima I, Masuda Medical Association Hospital; Nishi K, Hyogo Prefectural Awaji Hospital; Inoue H, Miki City Hospital; Yamada H, Maruno T, Shinko Hospital; Kitajima N, Kasai City Hospital; Kawamura A, Yuaikai Ono Municipal Hospital; Kawashima K, Matsue Seikyo General Hospital; Goubaru Y, Goubaru Clinic; Takatori Y, Takatori Clinic; Yuuki T, Matsue City Hospital; Fukuhara K, Abe Clinic; Honda C, Jusei Hospital; Maekawa T, Kanebo Memorial Hospital. Kamata T, Fujita M, Kawasaki Medical School; Sakakibara T, Sakakibara Hospital; Fujimura Y, Kawasaki Hospital; Kawanishi M, Unno M, Kamao T, Kaneda Hospital; Otani K, Otani Hospital; Yoneda M, Yoneda Medical Clinic; Iguchi D, Ochiai Hospital; Watanabe T, Watanabe Gastrointestinal Surgical Hospital; Miyashita K, Mitsubishi Mizushima Hospital; Koga H, Tanaka T, Tarumi K, Satou Memorial Hospital; Sugiu K, Sugiu Clinic; Nishina H, Shimizu K, Takeda M, Ueda Kinen Hospital; Ohumi T, Ohumi Clinic; Sasaki A, JA Onomichi General Hospital; Hamada H, Mitsubishi Mihara Hospital; Tokumo K, Tokumo Gastrointestinal Hospital; Suzuki T, Suzuki Medical Gastrointestinal Clinic; Miyajima N, Kasaoka Daiichi Hospital; Sano T, Sano Medical Clinic; Tanaka R, Kurashiki Heisei Hospital; Koduka K, Koduka Clinic; Kariya K, Mabi Central Hospital; Moritani Y, Moritani Surgical Clinic; Sato K, Sato Gastrointestinal Surgical Hospital; Murakami Y, Murakami Clinic; Nishioka T, Kanbe Clinic.
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Kusunoki, H., Kusaka, M., Kido, S. et al. Comparison of the effects of omeprazole and famotidine in treatment of upper abdominal symptoms in patients with reflux esophagitis. J Gastroenterol 44, 261–270 (2009). https://doi.org/10.1007/s00535-009-0003-4
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DOI: https://doi.org/10.1007/s00535-009-0003-4