Request PDF | Combined use of proton pump inhibitors and histamine-H2 receptor ... The proportion of patients who were heartburn-free was highest with PPIs ...HomeDigestiveSystemDiseasesGastrointestinalDiseasesStomachDiseasesInternalMedicineMedicineGastroenterologyGastroesophagealRefluxDiseaseArticleCombineduseofprotonpumpinhibitorsandhistamine-H2receptorantagonistsforGERDSeptember2002CanadianPharmaceuticalJournal135(7)Authors:DoretKFChengMountSinaiHospital,TorontoRequestfull-textPDFToreadthefull-textofthisresearch,youcanrequestacopydirectlyfromtheauthor.Requestfull-textDownloadcitationCopylinkLinkcopiedRequestfull-textDownloadcitationCopylinkLinkcopiedToreadthefull-textofthisresearch,youcanrequestacopydirectlyfromtheauthor.References(1)AbstractLifestylechangeshavenotbeenstudiedextensively;however,patientcounselingandimplementationofnon-pharma-cologicalmeasuresareintegraltothetreatmentofallstagesofGERD.H2RAswerehistoricallythemainstayoftherapyforGERD,particularlyforthesymptomatictreatmentofheartburn.Morerecently,PPIshaveassumedamoreprominentroleduetotheirpotentandlong-termsup-pressionofacidreleaseandsuperiorefficacyinhealingdocumentedesophagitis.2,3Ameta-analysisofrandom-izedcontrolledtrialsevaluatedthehealingratesandthedegreeofsymptomreliefprovidedbyH2RAsandPPIsinpatientswithGERDandmoderatetosevereesophagitis(GradeIItoIV).4TheoverallhealingproportionwasgreatestwithPPIs(83.6%)comparedwithH2RAs(51.9%),sucralfate(39.2%)orplacebo(28.2%).Theproportionofpatientswhowereheartburn-freewashighestwithPPIs(77.4%)comparedwithH2RAs(47.6%).Overall,PPIsshowedfasterhealingratesandmorecompleteheart-burnrelief.Thestudiesincludedinthismeta-analysiswererestrictedtothosethatassessedacutehealingofesophagitisratherthanmaintenancetherapyforrecur-rence.VariousPPIshavebeenapprovedinCanadafortheinitialtherapyofpatientswithmoresevereGERDsymptoms,thosewithendoscopicallydocumentedesophagitis,orthosewhohavenotrespondedtofourtoeightweeksofH2RAtherapy(Table1).NocturnalAcidBreakthroughDiscoverthewor