Cimetidine versus antacid in scleroderma with reflux esophagitis. A randomized double-blind controlled study

Area of Science:

• Gastroenterology
• Pharmacology

Background:

• Scleroderma patients often experience symptomatic reflux esophagitis.
• Reflux esophagitis management typically involves acid suppression and antacids.

Purpose of the Study:

• To compare the efficacy of cimetidine versus antacids in treating reflux esophagitis in scleroderma patients.
• To evaluate endoscopic changes and symptom relief.

Main Methods:

• Double-blind, cross-over controlled trial with 15 scleroderma patients.
• Patients received cimetidine (300 mg QID) or antacid (Mylanta II 30 ml QID/PRN) for 8 weeks, then switched regimens.
• Symptom severity assessed by interviews; esophagitis evaluated endoscopically.

Main Results:

• Cimetidine provided significantly greater heartburn relief than antacids.
• Cimetidine led to significant endoscopic improvement of esophageal mucosa; antacids had no effect.
• Neither treatment improved stricture size or lower esophageal sphincter pressure.
• Cimetidine was non-toxic; antacids frequently caused diarrhea.

Conclusions:

• Cimetidine is more effective than antacids for symptomatic relief and endoscopic healing in scleroderma-related reflux esophagitis.
• Cimetidine offers a safer alternative to antacids, which can cause adverse effects like diarrhea.