MANAGEMENT OF ACUTE GASTRODUODENAL PEPTIC -ULCER - SUPERIORITY OF OMEPRAZOLE TO RANITIDIN IN THE EARLY PHASE OF ULCER HEALING

Omeprazole (OM) has been shown to be superior to H-2-Blockers in terms of complete healing rates of gastric (GU) and duodenal ulcers (DU). W e investigated in more detail the kinetics of ulcer healing under OM ( 20 mg mane) compared with ranitidine (RAN 300 mg nocte) in GU (n = 28) and DU (n = 27) by multiple series endoscopy. After endoscopic diagno sis (day 0) patients were allocated to either OM or RAN ina random ord er. Endoscopic controls were undertaken at day (d) 3, 7, 14, 21, 28, 4 2 up to complete ulcer healing. The seize of ulcer areas was assessed by independent endocopists estimating the longest and shortest diamete r D acc. to the formula A = pi x D1 x D2:4. Results: In GU and DU cumu lating healing rates were sign. higher under OM. In GU and DU, the mos t striking differences in the absolute and percentual reduction of ulc er seize in favour of OM vs RAN were observed mainly during the first week. At d3 under OM the reduction in DU-area was 43% and at d7 75% co mpared to a distinctly lower rate under RAN with the corresponding fig ures of 9% and 61% resp. In GU the mean reduction in area was for IM a t d3 41%, at d7 82% in contrast to RAN at d3 of 34% and d7 of 49%. The faster healing during the first week was accompanied by sign. more ra pid reduction in day-and-night-painscore during OM vs RAN. It is concl uded that the well known faster healing in acute UD and GU with OM com pared with RAN occurs mainly during the first week of therapy and that better effect on healing is accompanied by more rapid pain relief in the early phase of ulcer healing.