COMPARATIVE INVESTIGATION OF THE EFFECTS OF LANSOPRAZOLE AND RANITIDINE ON THE HISTOLOGICAL-FINDINGS OF GASTROESOPHAGEAL REFLUX DISEASE

The superiority of proton pump inhibitors (PPI) over H-2 receptor anta gonists in the treatment of gastro-oesophageal reflux disease (GERD) h as, to date, been confirmed only for symptoms and endoscopic findings, bur not for histological findings, The present study was therefore in itiated with the aim of establishing whether this superiority also app lies in terms of improvements in histological findings. The material i nvestigated were biopsies obtained from erosions or ulcers (3 particle s) in the distal oesophagus, and two biopsies from endoscopically, nor mal-appearing squamous epithelium of the oesophagus in the region of t he cardio-oesophageal junction prior to and after 28 days of treatment with 30 mg lansoprazole (LAN) mane or 300 mg ranitidine (RAN) nocte. Histologically a search was made for the presence of fibrinoid necrose s from erosions or ulcers, and for hyperregenerative oesophagopathy (g rading: 0 to III) After a 28-day course of treatment the incidence of ulcers (day 0: 31.3% day 28: 1.2%) and erosions (day 0: 24.2%, day 28: 5.9%) were highly significantly less common in the LAM group (n = 84) than in the RAN group (n = 46: ulcers: day 0: 44.0%, day 28: 23.4%, e rosions: day 0: 20.8%, day 28: 14.9%). The grading of hyperregenerativ e oesophagopathy revealed, in the RAM group. no difference before and after treatment In contrast the LAN group showed a highly significant post-treatment improvement in this pathological finding. The results o f the present study show that 4-weeks of treatment of GERD with 30 mg LAN mane is unequivocally superior to 300 mg RAN node. also in terms o f the normalisation of the pathological findings in Vie distal oesopha gus. This superiority thus also applies nor only to the healing of ero sions and ulcers hut also to the normalisation of the hyperregenerativ e oesophagopathy.