[Reduced suppression of gastric acid by ranitidine in severe reflux esophagitis. A pilot study]

Repeated intragastric long-term pH recordings for 24 h were conducted in 13 patients with reflux oesophagitis grade III and IV (Savary and Miller) during treatment with ranitidine 150 mg b.i.d. and 300 mg b.i.d. and omeprazole 40 mg mane (n = 5). Ranitidine led to a significantly less pronounced increase in median gastric pH in oesophagitis than in healthy controls. The magnitude of intragastric pH increase showed parallelism to symptomatic response and healing. Omeprazole increased intragastric pH above 4 for 24 h and caused rapid healing in non-responders. It is concluded that in patients with severe reflux oesophagitis ranitidine is less effective in increasing intragastric pH than in controls, whereas omeprazole reveals potent antisecretory activity accompanied by rapid healing.