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Successful elimination of reflux symptoms does not insure adequate control of acid reflux in patients with Barrett's esophagus.
Am J Gastroenterol. 1994 Jul; 89(7):989-91.AJ

Abstract

OBJECTIVE

Patients with Barrett's metaplasia of the esophagus often lack the appropriate amount of heartburn for their severity of gastroesophageal reflux. Therefore, we studied patients with Barrett's metaplasia by prolonged ambulatory pH monitoring after completely suppressing their heartburn symptoms to determine whether acid reflux was underestimated in symptom assessment.

METHODS

Five patients with Barrett's esophagus, all of whom presented with heartburn, were treated with omeprazole (20-60 mg/day) until they were asymptomatic. Twenty-four-hour pH ambulatory monitoring was performed while they were on omeprazole.

RESULTS

Four of five patients showed persistent abnormal gastroesophageal reflux after treatment with omeprazole. Two patients showed abnormally increased supine reflux and two patients had an abnormal increase in both supine and upright reflux. Only one patient had complete inhibition of the acid reflux by the omeprazole (20 mg b.i.d.).

CONCLUSIONS

Treating the patient with Barrett's esophagus to the endpoint of eradication of heartburn does not insure adequate control of acid reflux. Prolonged ambulatory pH monitoring of the esophagus should be conducted to demonstrate that an adequate dose of omeprazole has been given, despite symptomatic improvement.

Authors+Show Affiliations

Department of Medicine, Graduate Hospital, Philadelphia, Pennsylvania.No affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

8017396

Citation

Katzka, D A., and D O. Castell. "Successful Elimination of Reflux Symptoms Does Not Insure Adequate Control of Acid Reflux in Patients With Barrett's Esophagus." The American Journal of Gastroenterology, vol. 89, no. 7, 1994, pp. 989-91.
Katzka DA, Castell DO. Successful elimination of reflux symptoms does not insure adequate control of acid reflux in patients with Barrett's esophagus. Am J Gastroenterol. 1994;89(7):989-91.
Katzka, D. A., & Castell, D. O. (1994). Successful elimination of reflux symptoms does not insure adequate control of acid reflux in patients with Barrett's esophagus. The American Journal of Gastroenterology, 89(7), 989-91.
Katzka DA, Castell DO. Successful Elimination of Reflux Symptoms Does Not Insure Adequate Control of Acid Reflux in Patients With Barrett's Esophagus. Am J Gastroenterol. 1994;89(7):989-91. PubMed PMID: 8017396.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Successful elimination of reflux symptoms does not insure adequate control of acid reflux in patients with Barrett's esophagus. AU - Katzka,D A, AU - Castell,D O, PY - 1994/7/1/pubmed PY - 1994/7/1/medline PY - 1994/7/1/entrez SP - 989 EP - 91 JF - The American journal of gastroenterology JO - Am J Gastroenterol VL - 89 IS - 7 N2 - OBJECTIVE: Patients with Barrett's metaplasia of the esophagus often lack the appropriate amount of heartburn for their severity of gastroesophageal reflux. Therefore, we studied patients with Barrett's metaplasia by prolonged ambulatory pH monitoring after completely suppressing their heartburn symptoms to determine whether acid reflux was underestimated in symptom assessment. METHODS: Five patients with Barrett's esophagus, all of whom presented with heartburn, were treated with omeprazole (20-60 mg/day) until they were asymptomatic. Twenty-four-hour pH ambulatory monitoring was performed while they were on omeprazole. RESULTS: Four of five patients showed persistent abnormal gastroesophageal reflux after treatment with omeprazole. Two patients showed abnormally increased supine reflux and two patients had an abnormal increase in both supine and upright reflux. Only one patient had complete inhibition of the acid reflux by the omeprazole (20 mg b.i.d.). CONCLUSIONS: Treating the patient with Barrett's esophagus to the endpoint of eradication of heartburn does not insure adequate control of acid reflux. Prolonged ambulatory pH monitoring of the esophagus should be conducted to demonstrate that an adequate dose of omeprazole has been given, despite symptomatic improvement. SN - 0002-9270 UR - https://www.unboundmedicine.com/medline/citation/8017396/Successful_elimination_of_reflux_symptoms_does_not_insure_adequate_control_of_acid_reflux_in_patients_with_Barrett's_esophagus_ L2 - http://www.diseaseinfosearch.org/result/743 DB - PRIME DP - Unbound Medicine ER -