Night-time intra-oesophageal bile and acid: a comparison between gastro-oesophageal reflux disease patients who failed and those who were treated successfully with a proton pump inhibitor.

Abstract

BACKGROUND:

Little is known about the contribution of bile and acid reflux to night-time symptoms generation in patients who failed PPI treatment.

AIM:

To compare the degree of night-time oesophageal acid and bile [by the surrogate duodenogastroesophageal reflux (DGER)] exposure between gastro-oesophageal reflux disease (GERD) patients who failed and those who fully responded to PPI once a day while on treatment.

METHODS:

Gastro-oesophageal reflux disease patients were assigned to the PPI failure group if they continued to report symptoms ≥3/week and to the PPI success group if they were asymptomatic for the last 3 months while on PPI once a day. All patients underwent upper endoscopy and subsequently simultaneous 24-h oesophageal Bilitec and pH testing while on PPI treatment.

RESULTS:

Twenty-three patients were enrolled into the PPI failure group and 24 patients into the PPI success group. The percentage of night-time pH<4 and the number of night-time acid reflux episodes were significantly higher in the PPI failure group as compared with the PPI success group. All night-time DGER parameters were similar between the PPI failure and PPI success groups.

CONCLUSIONS:

Night-time oesophageal acid exposure is significantly higher in the PPI failure group vs. PPI success group. The degree of night-time bile reflux is similar in the two groups of patients with GERD.

• Authors: T Hershcovici, L K Jha, H Cui, J Powers, R Fass
• Journal: Alimentary pharmacology & therapeutics (Aliment Pharmacol Ther) Vol. 33 Issue 7 Pg. 837-44 (Apr 2011) ISSN: 1365-2036 [Electronic] England
• PMID: 21261670 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2011 Blackwell Publishing Ltd.

Chemical References

• Proton Pump Inhibitors

Topics

• Adult
• Aged
• Bile (physiology)
• Bile Reflux (diagnosis)
• Circadian Rhythm
• Female
• Gastric Acid (physiology)
• Gastroesophageal Reflux (drug therapy)
• Humans
• Hydrogen-Ion Concentration
• Male
• Middle Aged
• Proton Pump Inhibitors (therapeutic use)
• Statistics as Topic
• Stomach (drug effects, physiology)
• Treatment Outcome