Relationship between intragastric acid control and healing status in the treatment of moderate to severe erosive oesophagitis

    loading  Checking for direct PDF access through Ovid

Abstract

Aim

To assess the relationship between the percentage of time intragastric pH >4.0 and healing of erosive oesophagitis.

Methods

In this proof-of-concept study, adults with endoscopically verified Los Angeles grade C or grade D erosive oesophagitis were randomly assigned to oral esomeprazole 10 or 40 mg once daily for 4 weeks. On day 5, patients underwent 24-h pH monitoring. At 4 weeks, erosive oesophagitis healing status was endoscopically assessed. Investigators scored gastro-oesophageal reflux disease symptoms on a 4-point scale [none to severe (0–3)] before and 4 weeks after treatment. The percentage of time intragastric pH was >4.0 and healing status were correlated and tested for significance using a Spearman rank correlation (r).

Results

103 patients had evaluable data (mean age, 48.7 years; 65% men). Mean percentages of time with intragastric pH >4.0 on day 5 in patients with healed and unhealed erosive oesophagitis were 61% and 42%, respectively (P = 0.0002), indicating that erosive oesophagitis healing rates were positively related to the percentage of time intragastric pH was >4.0. Greater intragastric acid control correlated with lower final daytime and night-time heartburn and acid regurgitation symptom scores (r = −0.029, −0.029 and −0.021; P = 0.003, 0.003 and 0.032, respectively).

Conclusion

A positive relationship between intragastric acid control and erosive oesophagitis healing was demonstrated.

Related Topics

    loading  Loading Related Articles