Background: There is considerable controversy about the degree of acid
suppression that is optimal for the treatment of peptic disorders. Ai
m: To compare the effects of three different regimens that are reporte
d to strongly inhibit acid secretion. Methods: Intragastric 24-hour pH
monitoring was performed in 11 healthy subjects in a randomized, mult
iple, cross-over, double-blind study, Each subject received four dose
regimens, each for 2 weeks, in a random order. The regimens were: 300
mg ranitidine b.d., 20 mg omeprazole o.m., 40 mg omeprazole o.m., and
placebo. Results: The decrease in gastric acidity during the daytime a
nd during the total 24-hour period by all three treatments was signifi
cantly greater than after placebo; a significant difference in acid in
hibition was found between ranitidine and 40 mg omeprazole, but not be
tween ranitidine and 20 mg omeprazole, nor between the two doses of om
eprazole, During the night-time the decrease in gastric acidity by all
three treatments was significantly greater than after placebo; no dif
ference was seen between the two doses of omeprazole and ranitidine, F
or the time of pH greater than 3 we found no statistical difference be
tween the various acid decreasing regimens, The pH remained significan
tly longer above 4 after ranitidine and the two doses of omeprazole co
mpared with placebo, and also longer above 4 after 40 mg omeprazole co
mpared with ranitidine, but not after 20 mg omeprazole compared with r
anitidine, nor after the two different doses of omeprazole. Conclusion
s: Dosing with 300 mg ranitidine b.d., 20 mg omeprazole or 40 mg omepr
azole is superior in gastric acid inhibition compared with placebo, wh
en measured using 24-hour pH monitoring.