Supplemental Use of H₂-Receptor Antagonists in Patients Who Take Daily PPIs

Physicians often recommend H₂-receptor antagonists to supplement the acid-suppressive effects of proton-pump inhibitor (PPI) therapy in patients with gastroesophageal reflux disease (GERD). In the U.S., this practice is facilitated by the over-the-counter availability of H₂-receptor antagonists. Although these drugs can reportedly influence the physiologic parameter of nocturnal acid breakthrough, their routine supplemental use has not been well studied.

In this industry-sponsored study, researchers evaluated 386 patients with erosive esophagitis who were taking PPIs every morning for GERD. A total of 41 patients (10.6%) reported having at least two episodes of nocturnal heartburn weekly and were invited to participate in a trial of suppleme…