{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T19:55:13Z","timestamp":1765655713532,"version":"3.48.0"},"reference-count":29,"publisher":"BMJ","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Gut"],"published-print":{"date-parts":[[1994,6]]},"abstract":"<jats:p>The gastrojet, a closed loop pH feedback infusion pump capable of maintaining intragastric pH at a target value by infusing H2 blockers at variable rates, was used to assess factors influencing the quantity of famotidine required to maintain intragastric pH above 4 for 24 hours in 34 fed patients with duodenal ulcers. The following factors were considered: sex, age, duration of the disease, previous bleeding, previous poor response to H2 blockers (ulcer unhealed at six weeks, or recurrence within three months during maintenance treatment), activity of the ulcer disease, smoking habits, cirrhosis. The patients had taken no antisecretory drugs for the 15 days before the study. Two standardised meals were given during the study period (from 1000 to 1000). Fifty ml of famotidine (4 mg\/ml) was loaded into infusion bags and the pump was programmed to deliver the drug intravenously at 11 rates varying from 0 to 40 microliters\/min. The target pH was 4. Mean famotidine use was 111 mg (range 33 to 200), the 23 hour median pH was 5.3, and the mean time during which pH was above 4 was 75.4%. There was a negative correlation (p &lt; 0.001) between famotidine delivery and the inhibition of gastric acidity. Statistical analysis showed that only cirrhosis significantly influenced drug delivery, median pH, and the time during which pH was above 4. Mean drug delivery in the cirrhotic and non-cirrhotic patients was 135 v 97 mg (p &lt; 0.04), 23 hour median pH was 4.7 v 5.6 (p &lt; 0.01), and the mean time at pH &gt; 4 was 65.9 v 81.6% (p &lt; 0.01). There were large interindividual variations in famotidine requirements, but not only cirrhosis was predictive of dose requirement. These results suggest that the appropriate amount of famotidine to treat duodenal ulcer in cirrhotic patients is probably higher than the usually recommended dose.<\/jats:p>","DOI":"10.1136\/gut.35.6.750","type":"journal-article","created":{"date-parts":[[2007,9,18]],"date-time":"2007-09-18T17:41:31Z","timestamp":1190137291000},"page":"750-754","source":"Crossref","is-referenced-by-count":1,"title":["Maintenance of intragastric pH &gt; 4 with famotidine in duodenal ulcer patients: factors influencing drug requirements."],"prefix":"10.1136","volume":"35","author":[{"given":"J C","family":"Delchier","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F","family":"Roudot-Thoraval","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L","family":"Stanescu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M C","family":"Deharvengt","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L","family":"Elouaer Blanc","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[1994,6,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1016\/0016-5085(90)91015-X","article-title":"Is there an optimal degree of acid suppression for healing of duodenal ulcers? 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Gastroenterol Clin Biol 1985; 9: 583-9.","journal-title":"Gastroenterol Clin Biol"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1007\/BF01536057","article-title":"Refractory duodenal ulcers (nonhealing duodenal ulcers with standard doses of antisecretory medication)","volume":"34","author":"Collen, M.J.; Stanczak, V.J.; Ciarleglio, C.A.","year":"1989","unstructured":"Collen MJ, Stanczak VJ, Ciarleglio CA. Refractory duodenal ulcers (nonhealing duodenal ulcers with standard doses of antisecretory medication). Dig Dis Sci 1989; 34: 233-7.","journal-title":"Dig Dis Sci"},{"key":"ref_5","first-page":"95","article-title":"Smoking impairs therapeutic gastric inhibition","volume":"i:","author":"Boyd, E.J.S.; Wilson, J.A.; Wormsley, K.G.","year":"1983","unstructured":"Boyd EJS, Wilson JA, Wormsley KG. Smoking impairs therapeutic gastric inhibition. Lancet 1983; i: 95-7.","journal-title":"Lancet"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1136\/gut.28.5.549","article-title":"Does smoking interfere with the effect of histamine H2 receptor antagonists on intragastric acidity in man?","volume":"28","author":"Bauerfeind, P.; Cilluffo, T.; Fimmel, C.J.; Emde, C.; Von Ritter, C.; Kohler, W.","year":"1987","unstructured":"Bauerfeind P, Cilluffo T, Fimmel CJ, Emde C, Von Ritter C, Kohler W, et al. Does smoking interfere with the effect of histamine H2 receptor antagonists on intragastric acidity in man? Gut 1987; 28: 549-56.","journal-title":"Gut"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1105","DOI":"10.1136\/gut.30.8.1105","article-title":"Frequent nonresponse to histamine H2 receptor antagonists in cirrhotics","volume":"30","author":"Walker, S.; Krishna, D.R.; Klotz, U.; Bode, J.C.","year":"1989","unstructured":"Walker S, Krishna DR, Klotz U, Bode JC. Frequent nonresponse to histamine H2 receptor antagonists in cirrhotics. Gut 1989; 30: 1105-9.","journal-title":"Gut"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1246","DOI":"10.1136\/gut.31.11.1246","article-title":"Use of automatic computerised pump to maintain constant intragastric pH","volume":"31","author":"Hannan, A.; Chesner, I.; Merki, H.S.; Mann, S.; Walt, R.P.","year":"1990","unstructured":"Hannan A, Chesner I, Merki HS, Mann S, Walt RP. Use of automatic computerised pump to maintain constant intragastric pH. Gut 1990; 31: 1246-9.","journal-title":"Gut"},{"key":"ref_9","first-page":"55","article-title":"H2 antagonists can suppress food stimulated acidity","volume":"98","author":"Hannan, A.; Chesner, I.; Mann, S.; Walt, R.P.","year":"1990","unstructured":"Hannan A, Chesner I, Mann S, Walt RP. H2 antagonists can suppress food stimulated acidity. Gastroenterology 1990; 98: A55.","journal-title":"Gastroenterology"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1136\/gut.31.2.148","article-title":"Effects of food on H2 receptor blockade in normal subjects and duodenal ulcer patients","volume":"31","author":"Merki, H.S.; Halter, F.; Wilder-Smith, C.; Allemann, P.; Witzel, L.; Kempf, M.","year":"1990","unstructured":"Merki HS, Halter F, Wilder-Smith C, Allemann P, Witzel L, Kempf M, et al. Effects of food on H2 receptor blockade in normal subjects and duodenal ulcer patients. Gut 1990; 31: 148-50.","journal-title":"Gut"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1136\/gut.29.4.453","article-title":"Continuous intravenous infusions of famotidine maintain high intragastric pH in duodenal ulcer","volume":"29","author":"Merki, H.S.; Witzel, L.; Kafman, D.; Kempf, M.; Neumann, J.; Roehmel, J.","year":"1988","unstructured":"Merki HS, Witzel L, Kafman D, Kempf M, Neumann J, Roehmel J, et al. Continuous intravenous infusions of famotidine maintain high intragastric pH in duodenal ulcer. Gut 1988; 29: 453-7.","journal-title":"Gut"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1583","DOI":"10.1136\/gut.29.11.1583","article-title":"Pattern of 24 hour intragastric acidity in active duodenal ulcer disease and in healthy controls","volume":"29","author":"Merki, H.S.; Fimmel, C.J.; Walt, R.P.; Harre, K.; Roehmel, J.; Witzel, L.","year":"1988","unstructured":"Merki HS, Fimmel CJ, Walt RP, Harre K, Roehmel J, Witzel L. 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Effects of cirrhosis and ageing on the elimination and bioavailability of ranitidine. Gut 1982; 23: 819-23.","journal-title":"Gut"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1007\/BF01300694","article-title":"Pharmacokinetics and bioavailability of ranitidine in normal subjects and cirrhotic patients","volume":"31","author":"Morichau-Beachant, M.; Houin, G.; Mavier, P.; Alexandre, C.; Dhumeaux, D.","year":"1986","unstructured":"Morichau-Beachant M, Houin G, Mavier P, Alexandre C, Dhumeaux D. Pharmacokinetics and bioavailability of ranitidine in normal subjects and cirrhotic patients. Dig Dis Sci 1986; 31: 113-8.","journal-title":"Dig Dis Sci"},{"issue":"2","key":"ref_21","first-page":"29","article-title":"Famotidine pharmacokinetics following oral and intravenous administration in patients with liver disease: results of a preliminary study","volume":"62","author":"Morgan, M.Y.; Stambuck, D.","year":"1986","unstructured":"Morgan MY, Stambuck D. 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Ital Jf Gastroenterol 1992; 24: 122-5.","journal-title":"Ital Jf Gastroenterol"}],"container-title":["Gut"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/gut.35.6.750","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T19:52:12Z","timestamp":1765655532000},"score":1,"resource":{"primary":{"URL":"https:\/\/gut.bmj.com\/lookup\/doi\/10.1136\/gut.35.6.750"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1994,6]]},"references-count":29,"journal-issue":{"issue":"6","published-online":{"date-parts":[[1994,6,1]]},"published-print":{"date-parts":[[1994,6]]}},"alternative-id":["10.1136\/gut.35.6.750"],"URL":"https:\/\/doi.org\/10.1136\/gut.35.6.750","relation":{},"ISSN":["0017-5749","1468-3288"],"issn-type":[{"type":"print","value":"0017-5749"},{"type":"electronic","value":"1468-3288"}],"subject":[],"published":{"date-parts":[[1994,6]]}}}