The effectiveness of
cimetidine vs.
antacid in the treatment of patients with scleroderma and symptomatic
reflux esophagitis was studied in a double-blind cross-over controlled trial. Fifteen patients were initially randomized to either
cimetidine (300 mg four times daily) with placebo
antacid, or placebo
tablet (1 four times daily) with
Mylanta II (30 ml four times daily and PRN). After 8 wk of
therapy on the initial regimen, each patient was crossed over to the alternate regimen for an additional 8 wk of
therapy. The severity of symptoms during each treatment period was estimated by patient interviews and changes in
esophagitis were evaluated endoscopically.
Cimetidine gave significantly greater relief of
heartburn than
antacid regardless of the initial randomization.
Cimetidine also resulted in significant endoscopic improvement of the esophageal mucosa whereas
antacid was without effect. Neither
cimetidine nor
antacid produced any improvement in
esophageal stricture size or lower esophageal sphincter pressure.
Cimetidine was without toxicity whereas
antacid therapy frequently produced
diarrhea.