Jansen and colleagues conducted a study to determine the effect of increasing doses of ranitidine on features of gastroesophageal reflux among patients with erosive or ulcerative reflux esophagitis.

Investigators assessed the effects of 300mg twice daily and 300 mg four times daily ranitidine treatment given for 2 weeks. The study included eight patients with endoscopically confirmed grade II (erosions) or III (ulcerations) reflux esophagitis.

• With both the higher doses of ranitidine, in comparison with no treatment, significant reductions were noted in:
• total number of reflux episodes with pH below 4.0 (p < 0.05 and p < 0.01, respectively),
• number of episodes with pH below 4.0 lasting for more than 5 min (p < 0.01), and
• fraction of time that the esophagus was exposed to reflux with pH below 4.0 (p < 0.01).
• Median pH in the esophagus was significantly increased with both the regimens of ranitidine (p < 0.05).
• Ranitidine 300 mg four times a day appeared to be more effective than twice daily regimen in reducing the total number of reflux episodes with pH below 4.0 and the fraction of time that the intra-esophageal pH was less than 4.0 (p < 0.05).

Ranitidine leads to dose-dependent reduction in indicators of gastric acid reflux into the esophagus in patients with reflux esophagitis.

Source: Jansen JBMJ, Baak LC, Lamers CBHW. Effect of increasing doses of ranitidine on exposure of the oesophagus to gastric acid in patients with reflux oesophagitis. Scand J Gastroenterol. 1988;23(suppl 154):2-5.