Changes in basal secretion of gastric acid in patients with rheumatoid arthritis and osteoarthritis taking non-steroidal anti-inflammatory drugs
Abdulganieva, Diana; Belyanskaya, Nadejda
Kazan State Medical University, Kazan, Russian Federation
Aim: The objective of this study was to evaluate changes in basal secretion of gastric acid in patients with rheumatoid arthritis (RA) and osteoarthritis (OA) taking non-steroidal antiinflammatory drugs (NSAIDs).
Methods: 86 pts were enrolled into study, 39 pts with RA, mean age 4I.7±13.1, 33 pts with OA, mean age 51.6±8.2, and 14 healthy controls. All pts were undergone upper gastrointestinal endoscopy, 24-hours pH-metry was done by "Gastroscan-24" (Fryazino, Russia), after previous discontinuation of PPI - 72 hours, H2-blockers - 48 hours prior to study. Basal secretion of gastric acid was assessed during the first hour of ph-metry. Diclofenac influence (50 mg po) was evaluated in 90 minutes after intake during further 30 minutes.
Results: Basal secretion of gastric acid was different. In RA hyperacidity was in 17(43,6%), normacidity in 6(15.4%), hypoacidity in 12(30.8%), anacidity in 4(10,2%) cases. In OA hyperacidity was in 13(39.4%), normacidity in 7(21,2%). hypoacidity in 9(27.3%), anacidity m 4(12.1%) pts. In controls hyperacidity was in 2(16,6%), normacidity in 8(66.8%), hypoacidity in 2(16.6%) people. After Diclofenac intake in RA pts in 20(60.6%) gastric acidity increased (p<0.05). in 13(39.4%) - decrease of gastric acidity (p<0.05). In OA pts in 21 (75%) we revealed decrease of gastric acid secretion (p<0.05), in 7(25%) cases - increased gastric acidity (p<0.05). In healthy controls - in 13(92.9%) people decrease of acidity was observed (p<0.05), in 1(7.1%) increase of acidity. There were relationship between basal acid secretion and changes of pH after Diclofenac intake in OA pts - decrease of gastric acidity was in pts with basal hypersecretion and normacidity in 16(76.2%), increase of acidity in pts with basal hypo- and anacidity - 6(85.7%) (p<0.05), in RA pts relationship were more complex, increase of acidity was observed. In healthy controls - decrease of gastric acidity (p<0.05). Conclusion: Both RA and OA pts showed evidence of changes in basal secretion of gastric acid (p<0.05). Diclofenac intake changes gastric acid secretion in rheumatologic pts (p<0,05): in RA pts increase of acidity, in OA pts-decrease of acidity (p<0.05). This changes may be due to secretion as well as mlcrovascular changes in rheumatologic pts, more prominent in RA.
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