Effects of cimetidine on biliary lipids in patients with reflux esophagitis.

In 14 patients with reflux esophagitis previously treated with antacids, the effects of addition of cimetidine on biliary lipids were studied. Each subject served as his own control, but no placebo medication was used. It was found that cimetidine (300 mg p.o. q.i.d.), over a 6-mo period of therapy, did not significantly alter lipid composition of fasting gallbladder bile, biliary lipid secretions, bile acid pool size, and its internal composition. In addition to detailed biliary studies, other observations were also made. Symptomatically, most of the patients responded favorably to cimetidine, and 9 of the 14 patients reported virtual elimination of bothersome symptoms while taking this medication. Concomitant with symptomatic improvement, daily antacid requirement was significantly reduced. Lower esophageal sphincter pressure was unaffected by cimetidine. No significant side effects were noted in this series of patients.