J A Todd1, K K Basu, J S de Caestecker. 1. Digestive Diseases Centre, University Hospitals of Leicester NHS Trust, Gwendolen Road, Leicester LE5 4PW, UK.
Abstract
BACKGROUND: Proton-pump inhibitors are effective at preventing the acid component of gastro-oesophageal refluxate from entering the oesophagus. It is not clear whether proton-pump inhibitors prevent duodenogastro-oesophageal reflux. AIM: To measure oesophageal exposure to duodenogastro-oesophageal refluxate while on proton-pump inhibitors in patients with Barrett's oesophagus. METHODS: Twenty-five patients (23 male) with Barrett's oesophagus underwent 24 h oesophageal pH and Bilitec 2000 monitoring while on omeprazole 40 mg/day (n = 19) or omeprazole 60 mg/day (n = 6). All patients were undergoing argon plasma ablation of their Barrett's epithelium as part of a clinical trial and the Bilitec measurements were only carried out after the ablation had been completed. RESULTS: 20 of 25 (80%) patients had a normal oesophageal pH profile. Fifteen of the 25 (60%) had abnormal oesophageal exposure to bile as measured by Bilitec 2000. Of the 20 patients who had a normal 24 h oesophageal pH profile, 11 (55%) had pathological exposure to bile in their oesophagus. CONCLUSION: Complete acid suppression does not guarantee elimination of duodenogastro-oesophageal reflux.
BACKGROUND: Proton-pump inhibitors are effective at preventing the acid component of gastro-oesophageal refluxate from entering the oesophagus. It is not clear whether proton-pump inhibitors prevent duodenogastro-oesophageal reflux. AIM: To measure oesophageal exposure to duodenogastro-oesophageal refluxate while on proton-pump inhibitors in patients with Barrett's oesophagus. METHODS: Twenty-five patients (23 male) with Barrett's oesophagus underwent 24 h oesophageal pH and Bilitec 2000 monitoring while on omeprazole 40 mg/day (n = 19) or omeprazole 60 mg/day (n = 6). All patients were undergoing argon plasma ablation of their Barrett's epithelium as part of a clinical trial and the Bilitec measurements were only carried out after the ablation had been completed. RESULTS: 20 of 25 (80%) patients had a normal oesophageal pH profile. Fifteen of the 25 (60%) had abnormal oesophageal exposure to bile as measured by Bilitec 2000. Of the 20 patients who had a normal 24 h oesophageal pH profile, 11 (55%) had pathological exposure to bile in their oesophagus. CONCLUSION: Complete acid suppression does not guarantee elimination of duodenogastro-oesophageal reflux.
Authors: Heather B Roesly; Mohammad R Khan; Hwu Dau Rw Chen; Kimberly A Hill; Nirushan Narendran; George S Watts; Xiaoxin Chen; Katerina Dvorak Journal: Am J Physiol Gastrointest Liver Physiol Date: 2012-02-02 Impact factor: 4.052