The burden of gastro-oesophageal reflux disease becomes apparent when one considers that treatment with acid suppressants accounts for a significant proportion of our national healthcare budget.¹ Oh et al present evidence in this issue of Gut² that a novel antioxidant substance (DA-9601) significantly attenuates the severity of oesophageal inflammation in a rat model of oesophagitis (see page 364). Furthermore, they demonstrated that DA-9601 was more effective in the prevention of oesophagitis than physiological concentrations of ranitidine.²

However, before we start prescribing antioxidants for gastro-oesophageal reflux disease, several factors need to be considered. Firstly, it is not clear why the authors chose to compare antioxidants with H₂ antagonists rather than with proton pump inhibitors. Large randomised controlled trials of oesophagitis suggest that whereas after eight weeks of treatment H₂ antagonists achieve complete healing in up to 60% of patients, proton pump inhibitors achieve endoscopically proved healing in approximately 90% of . . . [Full text of this article]