Volume, distribution and acidity of gastric secretion on and off proton pump inhibitor treatment: a randomized double-blind controlled study in patients with gastro-esophageal reflux disease (GERD) and healthy subjects

BMC Gastroenterology
A SteingoetterW Schwizer

Abstract

Postprandial accumulation of gastric secretions in the proximal stomach above the meal adjacent to the esophagogastric junction (EGJ), referred to as the 'acid pocket', has been proposed as a pathophysiological factor in gastro-esophageal reflux disease (GERD) and as a target for GERD treatment. This study assessed the effect of proton pump inhibitor (PPI) therapy on the volume, distribution and acidity of gastric secretions in GERD and healthy subjects (HS). A randomized, double blind, cross-over study in 12 HS and 12 GERD patients pre-treated with 40 mg pantoprazole (PPI) or placebo b.i.d. was performed. Postprandial secretion volume (SV), formation of a secretion layer and contact between the layer and the EGJ were quantified by Magnetic Resonance Imaging (MRI). Multi-channel pH-monitoring assessed intragastric pH. A distinct layer of undiluted acid secretion was present on top of gastric contents in almost all participants on and off high-dose acid suppression. PPI reduced SV (193 ml to 100 ml, in HS, 227 ml to 94 ml in GERD; p < 0.01) and thickness of the acid layer (26 mm to 7 mm, 36 mm to 9 mm respectively, p < 0.01). No differences in secretion volume or layer thickness were observed between groups; however, off treatme...Continue Reading

References

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Citations

Aug 4, 2016·Nature Reviews. Gastroenterology & Hepatology·Kornilia NikakiDaniel Sifrim
Oct 28, 2016·European Journal of Pharmaceutical Sciences : Official Journal of the European Federation for Pharmaceutical Sciences·Jens Van Den AbeelePatrick Augustijns
Jan 27, 2017·Annual Review of Food Science and Technology·Gail M Bornhorst
Sep 15, 2018·Neurogastroenterology and Motility : the Official Journal of the European Gastrointestinal Motility Society·Helen ParkerMark Fox
Sep 7, 2019·Food & Function·Yamile A Mennah-GovelaGail M Bornhorst
Sep 21, 2017·Molecular Pharmaceutics·Michael GrimmWerner Weitschies
May 1, 2018·ACS Applied Materials & Interfaces·Nathalie ScheublePeter Fischer
Sep 16, 2021·American Journal of Physiology. Gastrointestinal and Liver Physiology·Farid ZreikGiris Jacob

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Methods Mentioned

BETA
pull-through
contraception

Clinical Trials Mentioned

NCT01212614

Software Mentioned

IDL
nlme
MMS International
MATLAB
RStudio
R
R Foundation for
LinExp

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