1. Long-term effect of H2RA therapy on nocturnal gastric acid breakthrough 
William K. Fackler, Tina M. Ours, Michael F. Vaezi, Joel E. Richter 
Gastroenterology 
Volume 122, Issue 3, Pages (March 2002)
DOI: /gast
Copyright © 2002 American Gastroenterological Association Terms and Conditions

2. Fig. 1
Study algorithm. All individuals were free of medication affecting gastric acid production for at least 2 weeks before enrolling in the study. H. pylori status was evaluated during the initial visit. The study period lasted a total of 6 weeks, with all participants taking omeprazole 20 mg orally twice daily and ranitidine 300 mg orally at bedtime for the final 4 weeks. A total of 34 individuals were able to complete all 5 gastroesophageal pH studies.
Gastroenterology  , DOI: ( /gast )
Copyright © 2002 American Gastroenterological Association Terms and Conditions

3. Fig. 2
Data for all study participants showing percentage that supine time gastric pH level was less than 4 for the 5 study periods. Medians (left) with 25%–75% ranges (right) are calculated and presented for the individual means. Median values for all medical periods are significantly less than the period of no medication. The median pH value after 1 day of PPI twice daily plus H2RA use is significantly less than any other drug regimen. There is no difference between median values for the period of PPI twice-daily use alone and PPI twice-daily plus H2RA use for either 1 week or 1 month.
Gastroenterology  , DOI: ( /gast )
Copyright © 2002 American Gastroenterological Association Terms and Conditions

4. Fig. 3
The presence of NAB for the 4 study periods on medication. Nocturnal acid breakthrough is defined as the presence of gastric pH level of less than 4 for at least 1 hour while sleeping. Comparisons for significance are made between all patients for each study period. A significant decrease (P < 0.01) in nocturnal acid breakthrough is seen only for individuals taking PPI twice daily and H2RA for 1 day when compared with all other periods. □, GERD; ●, normals; ▤, all patients.
Gastroenterology  , DOI: ( /gast )
Copyright © 2002 American Gastroenterological Association Terms and Conditions

5. Fig. 4
Supine esophageal acid exposure periods of NAB for the 5 study groups. Abnormal esophageal acid exposure is defined as percent time that pH level is less than 4 of 3% or more during the supine period. Medians (left) with 25%–75% ranges (right) are calculated and presented from the individual means. All treatment regimens significantly decrease esophageal acid exposure. No statistical difference exists between any treatment regimens.
Gastroenterology  , DOI: ( /gast )
Copyright © 2002 American Gastroenterological Association Terms and Conditions

6. Fig. 5
The effect of drug adherence rates on the 4 identified subgroups of response to gastric acid suppression. The percentage of individuals showing either the H2RA tolerance response or PPI response patterns increases with more stringent adherence criteria whereas the percentage with either the H2RA response or unpredictable response decreases. ■, 75% compliance; □, 90% compliance.
Gastroenterology  , DOI: ( /gast )
Copyright © 2002 American Gastroenterological Association Terms and Conditions