Managing heartburn at the 'base' of the GERD 'iceberg': effervescent ranitidine 150 mg b.d. provides faster and better heartburn relief than antacids

Background: Many individuals with heartburn self-medicate with antacids for relief of their symptoms. Aim: To compare efficacy of effervescent ranitidine to as-needed calcium ca rbonate antacids in subjects who self-treat heartburn. Methods: A total of 155 subjects with frequent antacid-responsive heartburn were randomized to receive effervescent ranitidine 150 mg tablets b.d., or as-needed calcium carbonate 750 mg for 12 weeks. Endoscopic oesophagitis s everity and mucosal histology were assessed at baseline, and at weeks 6 and 12. Heartburn frequency, severity, and antacid consumption were recorded d aily, and quality of life was assessed at baseline, and at weeks 6 and 12. Results: Heartburn frequency and severity were significantly decreased afte r 1 day of ranitidine (P < 0.02). By week 6, ranitidine had significantly d ecreased rescue antacid consumption (7.3 tablets, P < 0.001) vs. antacids ( 14.1 tablets). Endoscopic oesophagitis healing (less than or equal to grade 1) was significantly better with ranitidine (55%, P=0.022) vs. antacids (2 9%). Quality of life was improved by both treatments; however, ranitidine w as numerically superior for all quality of life parameters, statistically s uperior for several quality of life indices at week 6 and for the pain-rela ted index by week 12 (P < 0.05). Conclusions: For subjects self-administering antacids for chronic heartburn , effervescent ranitidine 150 mg b.d. is more effective than antacids in re ducing heartburn, healing erosive oesophagitis, alleviating pain, and impro ving quality of life.