Measurement of postprandial changes in urine acid output to detect changes of gastric acid secretion after proton pump inhibitors in children.

Acid inhibition after proton pump inhibitors in children is variable, and to measure it by a noninvasive method may help to tailor treatment. To study gastric acid inhibition after a single dose of PPI, by measuring urinary acid output (UAO), which decreases as parietal cells release acid into the stomach during a meal, we performed a prolonged pH monitoring in 31 children (age range 3-16 yrs). Esophageal and intragastric pH was recorded for 24 hr and for 5 more hr after a single dose of PPI or placebo. Urine was collected early in the morning, and 1 hr after a test meal. Intragastric and urinary parameters were analyzed for 5 hr after PPI and compared to the same 5 hr at baseline. After PPI, median gastric pH significantly increased, and median AUAO became significantly smaller (-0.31 vs. -1.40 at baseline; P = 0.002) but was unchanged after placebo. Inhibition of gastric acid induced by PPI can be detected by changes in UAO and its determination may be useful to monitor the PPI effect.

RCT Entities:   Population Interventions Outcomes