[Medical treatments of reflux esophagitis - Proton pump inhibitors and histamine H2 receptor antagonists -].

Inhibitors of gastric acid secretion have been used as main drugs for the treatment of reflux esophagitis. Histamine H2 receptor antagonists (H2RA) and proton pump inhibitors(PPI) are the key drugs in acid inhibitors. Acid inhibition after the administration of H2RA quickly appears and its effect is potent during the nocturnal period. However, their acid inhibitory effect becomes attenuated because of the tolerance phenomenon only after 2-week-long oral administration. On the other hand, potent acid inhibition by PPI continues for long period and it is more potent during the day-time period when gastro-esophageal refluxes frequently occur. From the different characteristics of the two drugs, PPI is used as the first line thera- peutic drug for the treatment of reflux esophagitis, while H2RA is used as a su plementary drug for the patients with nocturnal refluxes.