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

  • Original Article—Alimentary Tract
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Abstract

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.

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Acknowledgments

There was no financial support for the study. We would like to thank the following investigators: Iwakiri R, Sakata H, Tsunada S, Ootani H, Sakata Y, Fujise T, Shimoda R, Shiraishi R, Watanabe K, Akiyama T, Saga Medical School; Okada K, Fujiyamato Onsen Hospital; Nakayama S, Kanzaki Clinic; Matsunaga C, Matsunaga Medical Clinic; Matsunaga K, Arima S, Sasebo Kyosai Hospital; Ogata S, Nakahara S, Mannen K, Saga Prefectural Hospital Koseikan; Kikkawa A, Takeo City Hospital; Tsuruta H, Kawazoe H, National Hospital Organization Ureshino Medical Center; Fujioka Y, Yamaguchi K, Fujioka Hospital; Sakata Y, Yuaikai Oda Hospital; Ishibashi S, Koga Pediatric Medical Hospital; Fujisaki J, Fujisaki Clinic; Mori H, Mori Clinic; Mitsuoka S, Mitsuoka Medical Gastrointestinal Clinic; Maeyama H, Maeyama Medical Gastrointestinal Clinic; Danjo A, Oyama T, Saga Social Insurance Hospital; Noda T, Matsumoto Y, Karatsu Red Cross Hospital; Endo H, Kojima M, Saiseikai Karatsu Hospital; Fukuyama K, Karatsu City Hospital Kitahata; Tomonaga M, Tomonaga Clinic; Tanaka T, Tanaka Medical Clinic; Fujimura T, Yamaguchi Hospital; Ono T, Ono Clinic; Tsuchihashi K, Tsuchihashi Clinic; Terada H, Terada Medical Clinic; Inutsuka S, Inutsuka Hospital; Kuwahara A, Omachi Municipal Hospital; Muto Y, Muto Medical Clinic; Moriyama M, Moriyama Medical Gastrointestinal Clinic; Sakata T, Sakata Clinic; Goto S, Amemori S, Taku City Hospital. Sakagami T, Nakajima K, Yamamoto N, Ohshima T, Hyogo College of Medicine; Yamamura M, Kobe Ekisaikai Hospital; Toyoda T, Nomura Kaihin Hospital; Arai E, Nishinomiya Kyoritsu Neurosurgical Hospital; Sawada Y, Takarazuka Municipal Hospital; Hayashi T, Amagasaki Central Hospital; Kishi K, Meiwa Hospital; Yamaji S, Seiwa Hospital; Hara H, Hara Surgery Clinic; Kuroda Y, Kuroda Clinic; Kishimoto Y, Kishimoto Clinic; Kang K, Asahi Clinic; Yamamoto I, Yamamoto Clinic; Akashi H, Akashi Clinic; Takahashi A, Tsukumo Memorial Hospital. Furuta K, Amano Y, Ishihara S, Sato S, Shimane University School of Medicine; Amano K, Masuda Red Cross Hospital; Okuyama T, Kurashiki Medical Center; Matsumori Y, Takatsuki General Hospital; Higashi R, Shibagaki K, Tottori Municipal Hospital; Niigaki M, Shimane Adult Disease Prevention Center; Hamamoto N, Unnan Municipal General Hospital; Mishima I, Masuda Medical Association Hospital; Nishi K, Hyogo Prefectural Awaji Hospital; Inoue H, Miki City Hospital; Yamada H, Maruno T, Shinko Hospital; Kitajima N, Kasai City Hospital; Kawamura A, Yuaikai Ono Municipal Hospital; Kawashima K, Matsue Seikyo General Hospital; Goubaru Y, Goubaru Clinic; Takatori Y, Takatori Clinic; Yuuki T, Matsue City Hospital; Fukuhara K, Abe Clinic; Honda C, Jusei Hospital; Maekawa T, Kanebo Memorial Hospital. Kamata T, Fujita M, Kawasaki Medical School; Sakakibara T, Sakakibara Hospital; Fujimura Y, Kawasaki Hospital; Kawanishi M, Unno M, Kamao T, Kaneda Hospital; Otani K, Otani Hospital; Yoneda M, Yoneda Medical Clinic; Iguchi D, Ochiai Hospital; Watanabe T, Watanabe Gastrointestinal Surgical Hospital; Miyashita K, Mitsubishi Mizushima Hospital; Koga H, Tanaka T, Tarumi K, Satou Memorial Hospital; Sugiu K, Sugiu Clinic; Nishina H, Shimizu K, Takeda M, Ueda Kinen Hospital; Ohumi T, Ohumi Clinic; Sasaki A, JA Onomichi General Hospital; Hamada H, Mitsubishi Mihara Hospital; Tokumo K, Tokumo Gastrointestinal Hospital; Suzuki T, Suzuki Medical Gastrointestinal Clinic; Miyajima N, Kasaoka Daiichi Hospital; Sano T, Sano Medical Clinic; Tanaka R, Kurashiki Heisei Hospital; Koduka K, Koduka Clinic; Kariya K, Mabi Central Hospital; Moritani Y, Moritani Surgical Clinic; Sato K, Sato Gastrointestinal Surgical Hospital; Murakami Y, Murakami Clinic; Nishioka T, Kanbe Clinic.

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Authors and Affiliations

  1. Department of General Medicine, Kawasaki Medical School, 577 Matsushima, Kurashiki, 701-0192, Japan

    Hiroaki Kusunoki

  2. Department of Internal Medicine, Kusaka Hospital, Bizen, Japan

    Masayasu Kusaka

  3. Department of Internal Medicine, Hiroshima General Hospital of West Japan Railway Company, Hiroshima, Japan

    Soichiro Kido

  4. Department of Internal Medicine, Mitsubishi Mihara Hospital, Mihara, Japan

    Ryo Yamauchi

  5. Department of Internal Medicine, Kawasaki Hospital, Kawasaki Medical School, Okayama, Japan

    Yoshinori Fujimura

  6. Watanabe Clinic, Kasaoka, Japan

    Yasuyuki Watanabe

  7. Department of Internal Medicine, Setonaikai Hospital, Imabari, Japan

    Michio Kobori

  8. Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan

    Hiroto Miwa, Toshihiko Tomita, Yongmin Kin & Kazutoshi Hori

  9. Department of Internal Medicine, Kyoritsu Hospital, Kawanishi, Japan

    Nobuo Tano

  10. Sugimoto Kenji Clinic, Suita, Japan

    Kenji Sugimoto

  11. Department of Internal Medicine I, Kyowa Marina Hospital, Nishinomiya, Japan

    Yoshihiro Nakamura

  12. Department of Internal Medicine, Saga University, Saga, Japan

    Kazuma Fujimoto & Noriko Oza

  13. Department of Internal Medicine, Eguchi Hospital, Ogi, Japan

    Aki Matsunobu & Naofumi Ono

  14. Department of Internal Medicine, Fuyuno Hospital, Karatsu, Japan

    Seisuke Fuyuno

  15. Department of Gastroenterolgy and Hepatology, Shimane University School of Medicine, Izumo, Japan

    Yoshikazu Kinoshita & Kyoichi Adachi

  16. Department of Internal Medicine, Izumo City Medical Center, Izumo, Japan

    Mika Yuki

  17. Department of Gastroenterology, Matsue Red Cross Hospital, Matsue, Japan

    Tomoo Fujisawa

  18. Department of Internal Medicine, Kawasaki Medical School, 577 Matsushima, Kurashiki, 701-0192, Japan

    Ken Haruma

Authors
  1. Hiroaki Kusunoki
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  2. Masayasu Kusaka
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  3. Soichiro Kido
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  4. Ryo Yamauchi
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  5. Yoshinori Fujimura
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  6. Yasuyuki Watanabe
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  7. Michio Kobori
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  8. Hiroto Miwa
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  10. Yongmin Kin
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  11. Kazutoshi Hori
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  12. Nobuo Tano
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  13. Kenji Sugimoto
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  14. Yoshihiro Nakamura
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  15. Kazuma Fujimoto
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  16. Noriko Oza
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  17. Aki Matsunobu
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  18. Naofumi Ono
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  19. Seisuke Fuyuno
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  20. Yoshikazu Kinoshita
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  21. Kyoichi Adachi
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  22. Mika Yuki
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  23. Tomoo Fujisawa
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  24. Ken Haruma
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Corresponding authors

Correspondence to Hiroaki Kusunoki or Ken Haruma.

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Kusunoki, H., Kusaka, M., Kido, S. et al. Comparison of the effects of omeprazole and famotidine in treatment of upper abdominal symptoms in patients with reflux esophagitis. J Gastroenterol 44, 261–270 (2009). https://doi.org/10.1007/s00535-009-0003-4

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  • DOI: https://doi.org/10.1007/s00535-009-0003-4

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