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Query: UMLS:C0017168 (gastroesophageal reflux disease)
 11,783 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The aim of this study was to analyze the results and the quality of methodology of 51 controlled double blind trials in the medical treatment of gastroesophageal reflux. The results of H2 receptor antagonist treatment were evaluated by the pooling method. Evaluation of methodology was carried out by using a special form filled in by two independent observers. The major criticisms in methodology were: small sample size, unblind evaluation of end-points, inappropriate statistical tests for small samples, and inaccurate handling of the withdrawals. There were only two trials concerning antacids versus placebo: one showed that Novaluzid improved symptoms and another that Maalox did not differ from placebo. The effectiveness of alginic acid and domperidone on either symptoms or endoscopic lesions was not demonstrated. Metoclopramide and bethanechol produced significant relief of reflux symptoms. Sucralfate and bethanechol were better than placebo in improvement of esophagitis endoscopic lesions. The H2-inhibitors efficiently relieved symptoms and esophagitis. Pooling analysis showed that H2-inhibitors were superior to placebo in the healing of esophagitis; the odds ratios were 2.5 for cimetidine and 3.3 for ranitidine, without significant difference. Omeprazole was better than ranitidine in relief of symptoms and esophagitis. The comparison of cimetidine alone with cimetidine plus metoclopramide showed that combined therapy was better in one trial out of two. New controlled trials are necessary to compare these different drugs and their association.
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PMID:[Treatment of gastroesophageal reflux: analysis of randomized double-blind trials]. 289 80

Although antacids have been the mainstay of pharmacologic therapy for reflux esophagitis, their effectiveness has not been tested in a placebo-controlled double-blind trial. We report a double-blind comparison of liquid antacid vs placebo in the treatment of reflux esophagitis in 32 patients with chronic heartburn. Entry criteria included the presence of symptomatic gastroesophageal reflux confirmed by both an acid perfusion (Bernstein) test and by intraesophageal pH probe. Drug treatment consisted of 15 ml (80 mEq) doses of antacid (Maalox Therapeutic Concentration, William H. Rorer) or placebo taken 7 times daily, ie, 1 and 3 hr after meals and at bedtime. Both groups showed significant improvement (P less than 0.05) in both frequency and severity of heartburn. The time to reproduce heartburn with the timed Bernstein test was increased with both active drug and placebo therapy. The mean increase was 402% (41 +/- 20 sec to 169 +/- 66 sec) for the placebo group and 286% (42 +/- 16 to 120 +/- 57 sec) in the antacid group. Both the antacid and placebo groups showed improvement in the degree of esophagitis as assessed endoscopically. The current study asked: does regular antacid therapy have a favorable influence on the natural history of symptomatic reflux esophagitis, ie, does therapy heal or otherwise change esophagitis so that painful episodes are either less frequent, less severe, or both? We found that the natural history of symptomatic reflux esophagitis was to improve with either antacid or placebo. There was no significant difference in antacid or placebo on the (short-term) natural history of the disease.
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PMID:Double-blind comparison of liquid antacid and placebo in the treatment of symptomatic reflux esophagitis. 634 11

Thirty three children aged 2 to 42 months (mean 9 months) with gastro-oesophageal reflux and peptic oesophagitis took part in a treatment trial comparing cimetidine (20 mg/kg/day) with an intensive regimen of antacids (Maalox, 700 mmol (mEq)/1 X 73 m2/day). All children were evaluated clinically and by radiology, acid reflux test, and endoscopy. After 12 weeks of treatment all were again evaluated clinically, by pH measurement, and endoscopy. Twenty nine children, 15 on antacid and 14 on cimetidine, completed the trial. Eight patients on antacid and seven on cimetidine were cured; five on antacid and six on cimetidine improved; and two patients on antacid and one on cimetidine underwent surgery. Both groups of children showed a statistically significant reduction in the score of clinical, pH, and endoscopic variables after treatment. Lower oesophageal sphincter pressure before treatment did not correlate significantly with the final total score. Antacids in large quantities are as effective as cimetidine in medical treatment of gastro-oesophageal reflux and peptic oesophagitis.
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PMID:Antacids and cimetidine treatment for gastro-oesophageal reflux and peptic oesophagitis. 638 68