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Beyond acid suppressants in gastro-oesophageal reflux disease
  1. R C FITZGERALD
  1. St Barts and the London School of Medicine and Dentistry
  2. London, UK
  3. r.c.fitzgerald@mds.qmw.ac.uk

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See article on page 364

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 Gut 2that 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 H2antagonists achieve complete healing in up to 60% of patients, proton pump inhibitors achieve endoscopically proved healing in …

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