Peghini PL, Katz PO, Bracy NA, Castell DO. Nocturnal recovery of gastric acid secretion with twice daily dosing of proton pump inhibitors. Am J Gastroenterol. 1998;93:763-7.

Авторы: Peghini P.L. / Katz P.O. / Bracy N.A.  / Castell D.O.

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Nocturnal recovery of gastric acid secretion with twice daily dosing of proton pump inhibitors

Paolo L. Peghini, Philip O. Katz, Nicole A. Bracy, and Donald O. Castell

The Esophageal Research Laboratory, Allegheny University Hospitals, Graduate Philadelphia, Pennsylvania

Objectives: It is our experience that many patients treated with proton pump inhibitors (PPI) b.i.d. recover acid secretion during the night. Our aim was to assess the efficacy of omeprazole and lansoprazole b.i.d. on nocturnal gastric acidity.

Methods: Three groups were studied with intragastric pH monitoring. Group 1 consisted of 17 patients with gastroesophageal reflux disease (GERD) taking omeprazole 20 mg b.i.d. Group 2 was 16 male volunteers taking omeprazole 20 mg b.i.d. and Group 3 comprised 12 volunteers taking lansoprazole 30 mg b.i.d.

Results: The percentages of time that subjects had pH < 4 were lower during supine than upright periods in Groups 1 and 3 (P < 0.01). Recovery of nocturnal acid secretion lasting > 1 h, termed acid breakthrough, occurred in three-fourths of all individuals within 12 h from intake of the evening dose of PPI. Median time to acid breakthrough for the whole group was 7.5 h.

Conclusion: Nocturnal acid breakthrough occurs in a majority of patients and normal volunteers taking PPI b.i.d.

Fig. 1. Acid breakthrough on therapy with PPI b.i.d.; 24-h intragastric pH profile. PPI is taken before dinner and before breakfast. At about 1:00 AM the intragastric pH drops < 4 (arrow) and remains below that level for > 4 h.

Рисунок 1. Ночной кислотный прорыв. 24-часовая рН-грамма желудка пациента, принимающего ингибитор протонной помпы (ИПП) дважды в сутки - перед завтраком и перед ужином. Примерно в 01:00 ночи pH в желудке падает меньше 4 (отмечено стрелкой) и остается ниже этого уровня более 4 часов.


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