Sucralfate versus cimetidine in reflux oesophagitis. The effect on oesophageal pH and motility

Sixty patients with endoscopically verified oesophagitis entered a double-blind study comparing the effect of 1 g of sucralfate granulate given four times a day and cimetidine, 400 mg twice a day. Fifty-two patients, 26 treated with cimetidine and 26 with sucralfate, were examined with short-term pH monitoring before and after 12 weeks of treatment. In about half of the patients, 19 treated with cimetidine and 11 treated with sucralfate, the oesophageal motility was studied with a radionuclide test before and after treatment. The sucralfate treatment did not affect either mean pH or the emptying rate but reduced the number of spikes. The cimetidine treatment increased mean pH and reduced the number of spikes but did not affect emptying rates. Both groups had significantly prolonged mean transit time (MTT) compared with healthy volunteers. MTT did not change after either treatment. The residual activity in the sitting position was significantly increased after cimetidine. It is concluded that the pharmacodynamic effect on oesophageal motility is different for the two drugs in question. Primary dysmotility might be involved in the pathogenesis of oesophagitis.