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논문 기본 정보

자료유형
학술저널
저자정보
Arun Karyampudi (Department of Gastroenterology SGPGIMS Lucknow India) Uday C Ghoshal (Department of Gastroenterology SGPGIMS Lucknow India) Rajan Singh (Department of Gastroenterology SGPGIMS Lucknow India) Abhai Verma (Department of Gastroenterology SGPGIMS Lucknow India) Asha Misra (Department of Gastroenterology SGPGIMS Lucknow India) Vivek A Saraswat (Department of Gastroenterology SGPGIMS Lucknow India)
저널정보
대한소화관운동학회(현 대한소화기능성질환.운동학회) Journal of Neurogastroenterology and Motility (JNM) Journal of Neurogastroenterology and Motility (JNM) Vol.23 No.2
발행연도
2017.1
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208 - 217 (10page)

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Background/Aims: Though nocturnal acid-breakthrough (NAB) is common in gastroesophageal reflux disease (GERD) patients, its clinical importance results from esophageal acidification, which has been shown to be uncommon. Ilaprazole, a long-acting proton pump inhibitor, may cause NAB infrequently. Accordingly, we studied prospectively, (1) frequency and degree of esophageal acidification during NAB, and (2) frequency and severity of NAB while on ilaprazole versus omeprazole. Methods: Fifty-eight consecutive patients with GERD on once daily ilaprazole, 10 mg (n = 28) or omeprazole, 20 mg (n = 30) for > one month underwent 24-hour impedance-pH monitoring prospectively. NAB was defined as intra-gastric pH < 4 for > one hour during night, and esophageal acidification as pH < 4 for any duration. Nocturnal symptoms (heartburn, regurgitation, and chest pain) were also recorded. Results: Of the 58 patients (age 35.5 [inter-quartile range 26.5–46.0] years, 38 [65.5%], 42 (72.4%) had NAB. Though patients with NAB had lower nocturnal intra-gastric pH than without (2.8 [1.9–4.1] vs 5.7 [4.6–6.8], P < 0.001), frequency and duration of nocturnal esophageal acidification (17/42 vs 4/16, P = 0.360 and 0.0 [0.0–1.0] vs 0.0 [0.0–0.3] minutes, P = 0.260, respectively) and symptoms were comparable (13/42 vs 6/16, P = 0.750). Though ilaprazole was associated with less NABs (1 [range 1–2, n = 19] vs 1 [range 1–3, n = 23], P = 0.010) than omeprazole, the frequency, duration, and mean intra-gastric pH during NAB were comparable (19/28 vs 23/30, P = 0.560; 117 [0–315] vs 159 [69–287] minutes, P = 0.500; 1.02 [0.7–1.4] vs 1.04 [0.44–1.3], P = 0.620, respectively). Conclusions: Though NAB was common while patients were on a proton pump inhibitor, esophageal acidification was uncommon. Frequency and severity of NAB were comparable among patients on ilaprazole and omeprazole, except for the lesser number of NABs with ilaprazole.

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참고문헌 (39)

참고문헌 신청
Cadiot G / 1997 / Multivariate analysis of pathophysiological factors in reflux oesophagitis / Gut 40:167~174 google schola Armstrong D / 2004 / Review article: gastric pH--the most relevant predictor of benefit in reflux disease? / Aliment Pharmacol Ther 20(suppl 5):19~26 google schola Bremner RM / 1992 / Concentration of refluxed acid and esophageal mucosal injury / Am J Surg 164:522~526 google schola Nzeako UC / 2002 / An evaluation of the clinical implications of acid breakthrough in patients on proton pump inhibitor therapy / Aliment Pharmacol Ther 16:1309~1316 google schola Katz PO / 1998 / Gastro-oesophageal reflux associated with nocturnal gastric acid breakthrough on proton pump inhibitors / Aliment Pharmacol Ther 12:1231~1234 google schola

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