COMPARISON OF THE EFFICACIES OF PROTON PUMP INHIBITORS AND H2 RECEPTOR ANTAGONISTS IN ON-DEMAND TREATMENT OF GASTROESOPHAGEAL REFLUX DISEASE

INTRODUCTION: On-demand treatment protocols in the maintenance treatment of gastroesophageal reflux disease (GERD) are cost-efficient and easy-to-use treatments.This study aimed to compare the efficacies of H2 receptor antagonists (H2RA) and proton pump inhibitors (PPI) in on-demand treatment of GERD. METHODS: Patients with persistent GERD symptoms were enrolledbetween January-November 2015 and were randomly separated into two equal groups. The patients in the first group were commenced on ranitidine 300 mg as H2RA and the patients in the second group were commenced on pantoprazole 40 mg. A 4-point Likert-type scale generated by the researchers was applied to evaluate the frequencies of reflux symptoms and their impacts on activities of life and business life. RESULTS: Fifty-two patients were included, of whom 26 (50.0%) were in the PPI group and 26 (50.0%) were in the H2RA group. There were no significant differences between the study groups both before and after treatment in terms of the severity of reflux symptoms. There were significant decreases in the H2RA group in terms of the domains of retrosternal burning sensation, regurgitation, nausea and vomiting, and burping (p=0.036, p=0.027, p=0.020, and p=0.038, respectively). DISCUSSION AND CONCLUSION: PPIs and H2RAs were both effective in maintaining symptom control and improving the limitations in work or activities in on-demand treatment.Nonetheless, the higher amount of the medication use in the H2RA group compared with the PPI group led us to conclude that using PPIs during on-demand treatment might be more appropriate than using H2RA in this setting.