Comparison of the effects of omeprazole and famotidine in treatment of upper abdominal symptoms in patients with reflux esophagitis

• Published in: Journal of gastroenterology Vol. 44; no. 4; pp. 261 - 270
• Main Authors: Kusunoki, Hiroaki, Kusaka, Masayasu, Kido, Soichiro, Yamauchi, Ryo, Fujimura, Yoshinori, Watanabe, Yasuyuki, Kobori, Michio, Miwa, Hiroto, Tomita, Toshihiko, Kin, Yongmin, Hori, Kazutoshi, Tano, Nobuo, Sugimoto, Kenji, Nakamura, Yoshihiro, Fujimoto, Kazuma, Oza, Noriko, Matsunobu, Aki, Ono, Naofumi, Fuyuno, Seisuke, Kinoshita, Yoshikazu, Adachi, Kyoichi, Yuki, Mika, Fujisawa, Tomoo, Haruma, Ken
• Format: Journal Article
• Language: English
• Published: Japan Japan : Springer Japan 01.04.2009; Springer Japan; Springer Nature B.V
• Subjects: Abdominal Surgery; Adult; Aged; Anti-Ulcer Agents - therapeutic use; Colorectal Surgery; Esophagitis, Peptic - drug therapy; Famotidine - therapeutic use; Female; Gastroenterology; Hepatology; Histamine H2 Antagonists - therapeutic use; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Omeprazole - therapeutic use; Original Article—Alimentary Tract; Proton Pump Inhibitors - therapeutic use; Severity of Illness Index; Surgical Oncology; Surveys and Questionnaires; Young Adult; Omeprazole; Famotidine; Upper abdominal symptoms
• ISSN: 0944-1174; 1435-5922
• DOI: 10.1007/s00535-009-0003-4

Purpose The purpose of this study was to compare the efficacy of proton pump inhibitor (PPI) with H₂ receptor antagonist (H₂RA) in treatment of upper abdominal symptoms. Methods This was a multi-center, open study conducted at 102 hospitals in Japan. Patients with reflux esophagitis received famotidine 10 mg twice daily for 2 weeks, then omeprazole 10 mg once daily for 2 weeks. Thereafter, patients were switched to famotidine 10 mg twice daily for a third 2-weekperiod, provided those with a medical condition agreed to continue the study. Patients evaluated the treatment response to each gastrointestinal symptom using a predefined patient questionnaire and gastrointestinal symptom rating scale (GSRS). Results 161 patients entered the study, of whom 8 were excluded from all analyses due to lack of participation following entry. Overall symptom improvement rate (n = 130) at week 4, after the 2-week omeprazole treatment, was 75.4% and this was significantly higher than that after the first 2-week famotidine treatment (41.5%) at week 2. In patients (n = 36) who completed 6 weeks of treatment, 2-week omeprazole treatment at week 4 showed a significantly higher overall symptom improvement rate compared with both the first 2-week and third 2-week famotidine treatments. Conclusions Omeprazole was superior to famotidine for treatment of upper abdominal symptoms in patients with reflux esophagitis, which suggested that gastric acid might be a cause not only of reflux symptoms, but also of ulcer symptoms and dysmotility symptoms such as epigastric pain and feeling of fullness in reflux esophagitis.