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Effect of omeprazole on antral duodenogastric reflux in Barrett oesophagus.
Scand J Gastroenterol. 2000 Aug; 35(8):796-801.SJ

Abstract

BACKGROUND

The effect of long-term acid suppression therapy in Barrett oesophagus remains unknown, but the high intragastric pH generated has been shown to increase the cytotoxicity of duodenal refluxate on foregut mucosa. However, recent work suggests that duodenogastric reflux (DGR) may be reduced by omeprazole.

AIM

To investigate the effect of omeprazole on the reflux of duodenal contents into the gastric antrum in Barrett patients and healthy subjects.

METHOD

Fifteen patients with Barrett oesophagus and 14 healthy subjects underwent oesophageal manometry followed by 24-h ambulatory oesophageal and gastric pH and gastric bilirubin monitoring. The bilirubin sensor (modified by the addition of a weighted tip to facilitate manoeuvrability) was sited in the gastric antrum under fluoroscopic control. Combined ambulatory pH and bilirubin monitoring was repeated after 2 weeks on omeprazole 20 mg b.d.

RESULTS

Changes in oesophageal acid reflux and gastric alkaline shift due to omeprazole were as expected (P < 0.001). There was no difference in total antral DGR between the Barrett and control groups (P = 0.56), and omeprazole had no significant effect on DGR in either group (P = 0.77 and 0.27, respectively).

CONCLUSIONS

DGR into the antrum is of a similar level in Barrett patients and healthy controls. Omeprazole does not reduce the reflux of duodenal contents across the pylorus. Further work is required on the increased cytotoxic potential of continuing DGR in those on long-term acid suppression.

Authors+Show Affiliations

Dept. of Surgery, Guy's Hospital, London, UK.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Controlled Clinical Trial
Journal Article

Language

eng

PubMed ID

10994616

Citation

Manifold, D K., et al. "Effect of Omeprazole On Antral Duodenogastric Reflux in Barrett Oesophagus." Scandinavian Journal of Gastroenterology, vol. 35, no. 8, 2000, pp. 796-801.
Manifold DK, Marshall RE, Anggiansah A, et al. Effect of omeprazole on antral duodenogastric reflux in Barrett oesophagus. Scand J Gastroenterol. 2000;35(8):796-801.
Manifold, D. K., Marshall, R. E., Anggiansah, A., & Owen, W. J. (2000). Effect of omeprazole on antral duodenogastric reflux in Barrett oesophagus. Scandinavian Journal of Gastroenterology, 35(8), 796-801.
Manifold DK, et al. Effect of Omeprazole On Antral Duodenogastric Reflux in Barrett Oesophagus. Scand J Gastroenterol. 2000;35(8):796-801. PubMed PMID: 10994616.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of omeprazole on antral duodenogastric reflux in Barrett oesophagus. AU - Manifold,D K, AU - Marshall,R E, AU - Anggiansah,A, AU - Owen,W J, PY - 2000/9/20/pubmed PY - 2001/2/28/medline PY - 2000/9/20/entrez SP - 796 EP - 801 JF - Scandinavian journal of gastroenterology JO - Scand. J. Gastroenterol. VL - 35 IS - 8 N2 - BACKGROUND: The effect of long-term acid suppression therapy in Barrett oesophagus remains unknown, but the high intragastric pH generated has been shown to increase the cytotoxicity of duodenal refluxate on foregut mucosa. However, recent work suggests that duodenogastric reflux (DGR) may be reduced by omeprazole. AIM: To investigate the effect of omeprazole on the reflux of duodenal contents into the gastric antrum in Barrett patients and healthy subjects. METHOD: Fifteen patients with Barrett oesophagus and 14 healthy subjects underwent oesophageal manometry followed by 24-h ambulatory oesophageal and gastric pH and gastric bilirubin monitoring. The bilirubin sensor (modified by the addition of a weighted tip to facilitate manoeuvrability) was sited in the gastric antrum under fluoroscopic control. Combined ambulatory pH and bilirubin monitoring was repeated after 2 weeks on omeprazole 20 mg b.d. RESULTS: Changes in oesophageal acid reflux and gastric alkaline shift due to omeprazole were as expected (P < 0.001). There was no difference in total antral DGR between the Barrett and control groups (P = 0.56), and omeprazole had no significant effect on DGR in either group (P = 0.77 and 0.27, respectively). CONCLUSIONS: DGR into the antrum is of a similar level in Barrett patients and healthy controls. Omeprazole does not reduce the reflux of duodenal contents across the pylorus. Further work is required on the increased cytotoxic potential of continuing DGR in those on long-term acid suppression. SN - 0036-5521 UR - https://www.unboundmedicine.com/medline/citation/10994616/Effect_of_omeprazole_on_antral_duodenogastric_reflux_in_Barrett_oesophagus_ L2 - http://www.tandfonline.com/doi/full/10.1080/003655200750023147 DB - PRIME DP - Unbound Medicine ER -