ARE FREQUENT SHORT GASTROESOPHAGEAL REFLUX EPISODES THE CAUSE OF SYMPTOMS IN PATIENTS WITH NONULCER DYSPEPSIA RESPONDING TO TREATMENT WITH RANITIDINE

Background: Patients with non-ulcer dyspepsia (NUD) responding to trea tment with H-2-receptor antagonists have no clinically useful characte ristics. This trial compares the gastro-oesophageal reflux pattern as measured by 24-h oesophageal pH monitoring in patients responding to r anitidine with that of non-responders. Methods: Thirty-one patients wi th NUD were randomized to 6 weeks' double-blind alternating treatment with 150 mg ranitidine twice daily or placebo and classified as respon ders or nonresponders. Results: Pathologic gastro-oesophageal reflux w as seen in 3 of the 13 responders and 4 of the 18 non-responders (NS). The responders had frequent short reflux episodes (< 1 min in duratio n). When 4 patients with greater than or equal to 5 reflux episodes lo nger than 5 min were excluded, the number of short reflux episodes (me dian) in responders and non-responders was 32 and 14, respectively. Th e difference is statistically significant (p = 0.025). There were no o ther differences between the groups. Conclusions: In this study patien ts with NUD responding to ranitidine were characterized by frequent sh ort reflux episodes in the absence of numerous long reflux episodes.