R. Tutuian

Bedtime H2 blockers improve nocturnal gastric acid control in GERD patients on proton pump inhibitors.

Proton pump inhibitors taken twice daily before meals (proton pump inhibitor b.d. AC) effectively controls daytime gastric pH; however, nocturnal gastric acid breakthrough (NAB) occurs in more than 75% of patients. Adding an H2‐blocker at bedtime decreases NAB in normal subjects. The efficacy of this regimen has not been evaluated in GERD patients. The aim of this study was to assess the effects of proton pump inhibitor b.d., both with and without bedtime H2‐blocker on intragastric pH and the occurrence of NAB in GERD patients.

Dose-dependent control of intragastric pH by pantoprazole, 10, 20 or 40 mg, in healthy volunteers

Proton pump inhibitors have emerged as the most effective class of drugs for the treatment of gastro‐oesophageal reflux. Pantoprazole is a proton pump inhibitor that has demonstrated high clinical efficacy.

Over-the-counter H2-receptor antagonists do not compromise intragastric pH control with proton pump inhibitors

Proton pump inhibitors effectively suppress intragastric acid. Nocturnal acid breakthrough occurs on any dosing regimen of oral proton pump inhibitors. Histamine2‐receptor antagonists (H2RA) suppress intragastric acidity independently of meals and help to control nocturnal acid breakthrough. Because proton pump inhibitors require an acid intragastric milieu for activation, nocturnal dosing of H2RA might decrease the effect of proton pump inhibitors taken in the morning by decreasing their gastric‐acid‐driven activation.

Prior botulinum toxin injection may compromise outcome of pneumatic dilatation in achalasia

Prior botulinum toxin injection may compromise outcome of pneumatic dilatation in achalasia

Addition of bedtime H2 blocker to PPI bid decreases nocturnal gastric acid burden in GERD patients

Addition of bedtime H 2 blocker to PPI bid decreases nocturnal gastric acid burden in GERD patients