[Reflux esophagitis: therapy with H2-blockers, and motility disorders]

In order to investigate the response of gastroesophageal reflux after medically induced healing of esophagitis and its relation to the occurrence of relapse during prophylactic treatment, 20 patients with erosive/ulcerative esophagitis underwent 24 hour esophageal pH monitoring before and after healing achieved with 12 to 24 weeks with ranitidine 150 or 300 mg bd. Compared with pretreatment values, after macroscopic healing, a significant reduction in daytime median percentage of reflux time and median number of reflux episodes lasting more than 5 min were observed, whereas during the night time reflux frequency and severity did not change. During maintenance treatment with ranitidine at half the acute dosage five of the six patients who had shown no improvement in gastroesophageal reflux after acute healing, relapsed. These results suggest that, in contrast to previous work, a decrease in gastroesophageal reflux in patients with reflux esophagitis can be achieved after macroscopic healing obtained with H2-antagonists, and that the occurrence of such a reduction after acute healing is predictive of a good response to long-term treatment.