Control of intra‐oesophageal <scp>pH</scp> in patients with <scp>B</scp>arrett's oesophagus on omeprazole‐sodium bicarbonate therapy

Gerson, Lauren B.; Mitra, Siddharta S.; Bleker, William F.; Yeung, Phil

doi:10.1111/j.1365-2036.2012.05016.x

Cited by 20 publications

(13 citation statements)

References 21 publications

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“…All of the PPIs with the exception of omeprazolesodium bicarbonate and dexlansoprazole, should be administered 30 -60 min before meals to assure maximal effi cacy. Omeprazolesodium bicarbonate, an immediate-release PPI, has been demonstrated to more eff ectively control nocturnal gastric pH in the fi rst 4 h of sleep compared with other PPIs when each is administered at bedtime ( 60 ). Whether this eff ect leads to any superior clinical outcomes including symptom control, requires further study.…”

Section: Summary Of the Evidencementioning

confidence: 99%

Guidelines for the Diagnosis and Management of Gastroesophageal Reflux Disease

Katz¹,

Gerson²,

Vela³

2013

American Journal of Gastroenterology

1,554

1,430

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Section: Summary Of the Evidencementioning

confidence: 99%

Guidelines for the Diagnosis and Management of Gastroesophageal Reflux Disease

Katz¹,

Gerson²,

Vela³

2013

American Journal of Gastroenterology

1,554

1,430

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“…It might be argued that baseline data were captured after a too limited period of time for duodeno-gastro-esophageal reflux to exert its full damaging effect. However, basically all similar studies have applied a corresponding or even shorter washout period[19,32,33]. Of note, the anti-reflux-operated patients had surgery more than 5 years before, but still displayed the same outcomes as those allocated to increasing doses of PPI.…”

Section: Discussionmentioning

confidence: 99%

Impact of gastroesophageal reflux control through tailored proton pump inhibition therapy or fundoplication in patients with Barrett’s esophagus

Baldaque‐Silva¹,

Debel²,

Håkanson³

et al. 2017

WJG

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AIMTo determine the impact of upwards titration of proton pump inhibition (PPI) on acid reflux, symptom scores and histology, compared to clinically successful fundoplication.METHODSTwo cohorts of long-segment Barrett’s esophagus (BE) patients were studied. In group 1 (n = 24), increasing doses of PPI were administered in 8-wk intervals until acid reflux normalization. At each assessment, ambulatory 24 h pH recording, endoscopy with biopsies and symptom scoring (by a gastroesophageal reflux disease health related quality of life questionnaire, GERD/HRLQ) were performed. Group 2 (n = 30) consisted of patients with a previous fundoplication.RESULTSIn group 1, acid reflux normalized in 23 of 24 patients, resulting in improved GERD/HRQL scores (P = 0.001), which were most pronounced after the starting dose of PPI (P < 0.001). PPI treatment reached the same level of GERD/HRQL scores as after a clinically successful fundoplication (P = 0.5). Normalization of acid reflux in both groups was associated with reduction in papillary length, basal cell layer thickness, intercellular space dilatation, and acute and chronic inflammation of squamous epithelium.CONCLUSIONThis study shows that acid reflux and symptom scores co-vary throughout PPI increments in long-segment BE patients, especially after the first dose of PPI, reaching the same level as after a successful fundoplication. Minor changes were found among GERD markers at the morphological level.

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“…Esomeprazole up to three times daily decreases this value to 16% [130]. In one recent trial an adequate control of intra-oesophageal acidity in 97% (14/15) of patients with primarily short-segment BE treated by Omeprazole-sodium bicarbonate twice daily was demonstrated [131]. In addition a 100% control of nocturnal oesophageal reflux assessed as 48 h supine intra-oesophageal pH was found.…”

Section: Antireflux Therapymentioning

confidence: 93%