PMID- 16483267
OWN - NLM
STAT- MEDLINE
DCOM- 20060821
LR  - 20131121
IS  - 0269-2813 (Print)
IS  - 0269-2813 (Linking)
VI  - 23 Suppl 1
DP  - 2006 Mar
TI  - Review article: physiologic and clinical effects of proton pump inhibitors on 
      non-acidic and acidic gastro-oesophageal reflux.
PG  - 25-32
AB  - The control of oesophageal acid exposure through gastric acid inhibition, as the 
      basis for gastro-oesophageal reflux disease (GERD) treatment, arose from the 
      apparent pH dependency of erosive oesophagitis and relationship to GERD symptoms. 
      The current perception is that reflux disease is an entirely acid-mediated 
      condition, and antisecretory therapies, particularly proton pump inhibitors, are 
      the treatment of choice for patients with erosive and non-erosive reflux disease. 
      A positive patient response to an empiric trial of proton pump inhibitor (PPI) 
      therapy, or the 'PPI test', is commonly suggested as a method of GERD diagnosis. 
      Recent studies have modified our understanding of the relationship between 
      oesophageal acid exposure and GERD pathology, manifestations and symptoms. 
      Whereas the use of PPIs to reduce oesophageal acid exposure in patients with 
      erosions is associated with increased healing rates, non-erosive reflux disease 
      patients are less likely to have an abnormal oesophageal pH profile. Patterns of 
      oesophageal acid exposure, particularly nocturnal oesophageal acid exposure, have 
      been linked to increased disease severity. Non-acidic reflux and the effect of 
      PPIs on this parameter, including bile reflux and the toxicity of bile acids, may 
      also be an important factor in GERD. This article explores some of these 
      assumptions, practices and relationships, including: the association between 
      oesophageal acid exposure and erosive and non-erosive gastro-oesophageal reflux 
      disease; the effect of PPIs on oesophageal acid exposure in erosive oesophagitis 
      patients; the influence of nocturnal acid secretion in GERD and the use of PPIs 
      to control this parameter; the relevance of the PPI test for reflux disease 
      diagnosis; and PPI influence on non-acidic reflux.
FAU - Miner, P B Jr
AU  - Miner PB Jr
AD  - Oklahoma Foundation for Digestive Disease, Oklahoma City, OK 73104, USA. 
      philip-miner@ouhsc.edu
LA  - eng
PT  - Journal Article
PT  - Review
PL  - England
TA  - Aliment Pharmacol Ther
JT  - Alimentary pharmacology & therapeutics
JID - 8707234
RN  - 0 (Anti-Ulcer Agents)
RN  - 0 (Proton Pump Inhibitors)
SB  - IM
MH  - Anti-Ulcer Agents/therapeutic use
MH  - Bile/physiology
MH  - Esophagitis, Peptic/etiology/physiopathology
MH  - Esophagus/physiopathology
MH  - Gastric Acid/physiology
MH  - Gastric Acidity Determination
MH  - Gastric Emptying/drug effects
MH  - Gastroesophageal Reflux/complications/*drug therapy/physiopathology
MH  - Humans
MH  - Hydrogen-Ion Concentration
MH  - *Proton Pump Inhibitors
MH  - Stomach/pathology
RF  - 32
EDAT- 2006/02/18 09:00
MHDA- 2006/08/22 09:00
CRDT- 2006/02/18 09:00
PHST- 2006/02/18 09:00 [pubmed]
PHST- 2006/08/22 09:00 [medline]
PHST- 2006/02/18 09:00 [entrez]
AID - APT2802 [pii]
AID - 10.1111/j.1365-2036.2006.02802.x [doi]
PST - ppublish
SO  - Aliment Pharmacol Ther. 2006 Mar;23 Suppl 1:25-32. doi: 
      10.1111/j.1365-2036.2006.02802.x.