CONTROL OF GASTRIC PH WITH RANITIDINE IN PATIENTS WITH CROHNS-DISEASERECEIVING TOTAL PARENTERAL-NUTRITION - COMPARISON OF 2 INTRAVENOUS REGIMENS

Eleven patients with Crohn's disease in remission who were receiving t otal parenteral nutrition (TPN) underwent continuous intragastric 24-h pH monitoring before and during ranitidine administration. The patien ts were randomly allocated to receive 200 mg/ day (group 1) or 400 mg/ day (group 2) of ranitidine by continuous infusion. The mean basal 24- h gastric pH was sustained at a low value. After raintidine administra tion, the mean pH increased significantly both in group 1 (from 2.13 t o 3.28) and in group 2 (from 1.91 to 3.36), with the mean holding-time at pH-3 also increasing significantly in both groups. There were no d ifferences in the mean pH or holding-time at pH-3 between the two grou ps during ranitidine administration; however, the plasma ranitidine co ncentration was significantly higher in group 2. These findings indica te that the continuous infusion of a standard dose of ranitidine exert ed a maximal inhibitory effect on the sustained hyperacidity induced b y TPN, but that this infusion was unable to maintain the intragastric pH level at above 3.5.