Abstract
A trend toward relapse of reflux symptoms and esophagitis during long-term treatment with proton pump inhibitors has been reported. The purpose of this study was to evaluate the existence of tachyphylaxia to the effect of proton pump inhibitors on gastric acidity and gastroesophageal reflux over time. A total of 23 patients with reflux esophagitis underwent 24-h intragastric and intraesophageal pH-metry after 7, 90, and 180 days of continued dosing with 20 mg of omeprazole once daily before breakfast. The total median percentages of time gastric pH <4 (interquartile range) were 49% (35-70%), 60% (36-76%), and 42% (26-66%) after 7, 90, and 180 days (p = 0.14). Percentages of time gastric pH <3 were 41%, 54%, and 34%, respectively (p = 0.19). The median percentages of total time esophageal pH <4 were 1.1%, 2.5%, and 1.1%, respectively (p = 0.70). Healing of esophagitis was achieved in 84% of the patients after 6 months. Heartburn improved in six, worsened in three, and was unchanged in 10 patients (p = 0.16). There was no statistical significant relationship between change in esophageal acid exposure and change in severity of heartburn. A dose of 20 mg of omeprazole once daily consistently controlled patients' symptoms and kept g...Continue Reading
References
Aug 1, 1990·Digestive Diseases and Sciences·C H Wilder-SmithH S Merki
Oct 1, 1990·Alimentary Pharmacology & Therapeutics·S Lanzon-MillerJ R Wood
Oct 1, 1990·Scandinavian Journal of Gastroenterology·T CilluffoA L Blum
May 1, 1990·Digestive Diseases and Sciences·P BauerfeindA L Blum
Feb 1, 1989·Alimentary Pharmacology & Therapeutics·C U NwokoloR E Pounder
Sep 1, 1987·Gut·F JohnssonP E Isberg
Apr 1, 1995·Gut·E F VerdúA L Blum
Apr 1, 1994·Alimentary Pharmacology & Therapeutics·W A de Boer, G N Tytgat
Aug 1, 1994·Annals of Internal Medicine·E C Klinkenberg-KnolS G Meuwissen
Apr 1, 1994·Alimentary Pharmacology & Therapeutics·S HurlimannF Halter
Apr 1, 1994·Gastroenterology·R MoreauD Lebrec
Mar 1, 1993·Scandinavian Journal of Gastroenterology·J G HatlebakkR Trondstad
Dec 1, 1995·Gut·E F VerdúA L Blum
Mar 1, 1996·Gastroenterology·J LabenzA L Blum
Oct 1, 1996·Scandinavian Journal of Gastroenterology·J G Hatlebakk, A Berstad
Apr 1, 1997·Alimentary Pharmacology & Therapeutics·J G Hatlebakk, A Berstad
Jun 1, 1997·Alimentary Pharmacology & Therapeutics·R CarlssonL Frison
Jan 29, 1999·Gastroenterology·D GillenK E McColl
Jan 19, 2000·The American Journal of Gastroenterology·L Lachman, C W Howden
Citations
Apr 7, 2005·Journal of Clinical Pharmacy and Therapeutics·L D AllgoodD A Peura
Mar 24, 2007·Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver·M FrazzoniV Savarino
Mar 6, 2003·Journal of the American Animal Hospital Association·Eveline HanKeith E Baer
Dec 17, 2009·Digestive Diseases and Sciences·Masaki SanakaYasushi Kuyama
Aug 7, 2003·Microbial Pathogenesis·Charles J CzuprynskiBrien Neudeck
Jul 8, 2005·Pharmacology & Therapeutics·Kjell Andersson, Enar Carlsson