Background and Aim: Efficacy of proton pump inhibitors (PPIs) on symptoms of gastroesophageal reflux (GER) is supposed to result from normalization of esophageal acid exposure; however, recent data in selected severe patients have challenged this concept. The aim of the study was to investigate 24-hour esophagogastric pH in unselected patients with GER disease in symptomatic remission during PPIs. Methods: Thirty of the 31 consecutive patients with heartburn enrolled achieved adequate symptom control (≤1 heartburn episode/wk) on PPIs o.d. (n=22) or b.d. (n=8); 3 refused pH monitoring, thus 27 tracings were analyzed. Results: Medians (Interquartile Range); Intragastric tracings showed a wide range of inhibition of acid secretion, 61.2% (49.7% to 80.2%) time at pH>4, nocturnal acid breakthrough being shorter (P=0.03) on PPIs b.d. compared with PPIs o.d., 125 minutes (90 to 247) versus 253 minutes (210 to 340). Esophageal acid exposure was 3.3% (1.4% to 7.9%) time at pH<4, 9 patients having increased exposure (ie, >5.5%), 7 of whom on PPIs o.d. Patients with increased acid GER on PPIs had a higher prevalence of esophagitis (67% vs. 22%, P<0.05) and hiatus hernia (78% vs. 39%, P<0.1) at endoscopy off PPIs. Conclusions: One third of unselected patients with GER disease asymptomatic on PPIs have an increased esophageal acid exposure, especially if their PPI is administered o.d.
Esophageal acid exposure on proton pump inhibitors in unselected asymptomatic gastroesophageal reflux disease patients / A. Grigolon , P. Cantù , D. Savojardo, D. Conte , R. Penagini. - In: JOURNAL OF CLINICAL GASTROENTEROLOGY. - ISSN 0192-0790. - 42:9(2008 Oct), pp. 969-973.
|Titolo:||Esophageal acid exposure on proton pump inhibitors in unselected asymptomatic gastroesophageal reflux disease patients.|
GRIGOLON, AUSILIA (Primo)
CANTU', PAOLO (Secondo)
CONTE, DARIO (Penultimo)
PENAGINI, ROBERTO (Ultimo)
|Parole Chiave:||Gastroesophageal reflux; pH monitoring; Proton pump inhibitors|
|Settore Scientifico Disciplinare:||Settore MED/12 - Gastroenterologia|
|Data di pubblicazione:||ott-2008|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1097/MCG.0b013e31814b8fc2|
|Appare nelle tipologie:||01 - Articolo su periodico|