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Proton pump inhibitor influence on reflux in Barrett's oesophagus.
Eur J Gastroenterol Hepatol 2008; 20(9):881-7EJ

Abstract

OBJECTIVES

It is important to identify factors responsible for the development of Barrett's oesophagus (BO). The effect of proton pump inhibitors (PPIs) on oesophageal clearance of both acid and alkaline reflux in these patients is uncertain and studies comparing BO patients and healthy controls (HCs) have not been performed earlier.

METHODS

Two groups of patients were studied: 18 HCs and 12 BO patients. Oesophageal motility, acid reflux and duodenogastro-oesophageal reflux (DGOR) were measured using a three-pressure transducer catheter with an antimony pH tip, connected to a sodium ion selective electrode. All patients were studied both on and off PPIs.

RESULTS

Without PPI therapy, BO patients had significantly more upright and supine acid reflux and upright DGOR compared with HCs. During acid reflux, HC demonstrated more peristalsis than BO [HC, % peristalsis=64 (9), BO=53 (8), P<0.01], but this was not seen during DGOR. [HC, % peristalsis=68 (14), BO=56 (11)]. In Barrett's patients, DGOR was significantly reduced with PPIs [off PPI, % upright DGOR=61 (17), on PPIs=19 (15), P<0.01], and no oesophageal motility differences were seen compared with results without PPIs.

CONCLUSION

HCs demonstrate better oesophageal motility compared with BO patients to prevent acid and alkaline reflux. When acid reflux occurred, HCs had better coordinated motility to remove it. This increased coordination did not occur during DGOR, suggesting different stimulation mechanisms. PPI reduced DGOR in BO patients, without any change in oesophageal motility.

Authors+Show Affiliations

Surgical Unit, Royal Hallamshire Hospital, Sheffield, England. A.Smythe@sheffield.ac.ukNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18794602

Citation

Smythe, Anne, et al. "Proton Pump Inhibitor Influence On Reflux in Barrett's Oesophagus." European Journal of Gastroenterology & Hepatology, vol. 20, no. 9, 2008, pp. 881-7.
Smythe A, Troy GP, Ackroyd R, et al. Proton pump inhibitor influence on reflux in Barrett's oesophagus. Eur J Gastroenterol Hepatol. 2008;20(9):881-7.
Smythe, A., Troy, G. P., Ackroyd, R., & Bird, N. C. (2008). Proton pump inhibitor influence on reflux in Barrett's oesophagus. European Journal of Gastroenterology & Hepatology, 20(9), pp. 881-7. doi:10.1097/MEG.0b013e3282f9b221.
Smythe A, et al. Proton Pump Inhibitor Influence On Reflux in Barrett's Oesophagus. Eur J Gastroenterol Hepatol. 2008;20(9):881-7. PubMed PMID: 18794602.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Proton pump inhibitor influence on reflux in Barrett's oesophagus. AU - Smythe,Anne, AU - Troy,Gill P, AU - Ackroyd,Roger, AU - Bird,Nigel C, PY - 2008/9/17/pubmed PY - 2008/12/30/medline PY - 2008/9/17/entrez SP - 881 EP - 7 JF - European journal of gastroenterology & hepatology JO - Eur J Gastroenterol Hepatol VL - 20 IS - 9 N2 - OBJECTIVES: It is important to identify factors responsible for the development of Barrett's oesophagus (BO). The effect of proton pump inhibitors (PPIs) on oesophageal clearance of both acid and alkaline reflux in these patients is uncertain and studies comparing BO patients and healthy controls (HCs) have not been performed earlier. METHODS: Two groups of patients were studied: 18 HCs and 12 BO patients. Oesophageal motility, acid reflux and duodenogastro-oesophageal reflux (DGOR) were measured using a three-pressure transducer catheter with an antimony pH tip, connected to a sodium ion selective electrode. All patients were studied both on and off PPIs. RESULTS: Without PPI therapy, BO patients had significantly more upright and supine acid reflux and upright DGOR compared with HCs. During acid reflux, HC demonstrated more peristalsis than BO [HC, % peristalsis=64 (9), BO=53 (8), P<0.01], but this was not seen during DGOR. [HC, % peristalsis=68 (14), BO=56 (11)]. In Barrett's patients, DGOR was significantly reduced with PPIs [off PPI, % upright DGOR=61 (17), on PPIs=19 (15), P<0.01], and no oesophageal motility differences were seen compared with results without PPIs. CONCLUSION: HCs demonstrate better oesophageal motility compared with BO patients to prevent acid and alkaline reflux. When acid reflux occurred, HCs had better coordinated motility to remove it. This increased coordination did not occur during DGOR, suggesting different stimulation mechanisms. PPI reduced DGOR in BO patients, without any change in oesophageal motility. SN - 0954-691X UR - https://www.unboundmedicine.com/medline/citation/18794602/Proton_pump_inhibitor_influence_on_reflux_in_Barrett's_oesophagus_ L2 - http://Insights.ovid.com/pubmed?pmid=18794602 DB - PRIME DP - Unbound Medicine ER -