PMID- 18498663
OWN - NLM
STAT- MEDLINE
DCOM- 20080620
LR  - 20211020
IS  - 1471-230X (Electronic)
IS  - 1471-230X (Linking)
VI  - 8
DP  - 2008 May 23
TI  - Time esophageal pH < 4 overestimates the prevalence of pathologic esophageal 
      reflux in subjects with gastroesophageal reflux disease treated with proton pump 
      inhibitors.
PG  - 15
LID - 10.1186/1471-230X-8-15 [doi]
AB  - BACKGROUND: A Stanford University study reported that in asymptomatic GERD 
      patients who were being treated with a proton pump inhibitor (PPI), 50% had 
      pathologic esophageal acid exposure. AIM: We considered the possibility that the 
      high prevalence of pathologic esophageal reflux might simply have resulted from 
      calculating acidity as time pH < 4. METHODS: We calculated integrated acidity and 
      time pH < 4 from the 49 recordings of 24-hour gastric and esophageal pH from the 
      Stanford study as well as from another study of 57 GERD subjects, 26 of whom were 
      treated for 8 days with 20 mg omeprazole or 20 mg rabeprazole in a 2-way 
      crossover fashion. RESULTS: The prevalence of pathologic 24-hour esophageal 
      reflux in both studies was significantly higher when measured as time pH < 4 than 
      when measured as integrated acidity. This difference was entirely attributable to 
      a difference between the two measures during the nocturnal period. Nocturnal 
      gastric acid breakthrough was not a useful predictor of pathologic nocturnal 
      esophageal reflux. CONCLUSION: In GERD subjects treated with a PPI, measuring 
      time esophageal pH < 4 will significantly overestimate the prevalence of 
      pathologic esophageal acid exposure over 24 hours and during the nocturnal 
      period.
FAU - Gerson, Lauren B
AU  - Gerson LB
AD  - Stanford University School of Medicine, Stanford, CA, USA. 
      lgerson@stanfordmed.org
FAU - Triadafilopoulos, George
AU  - Triadafilopoulos G
FAU - Sahbaie, Peyman
AU  - Sahbaie P
FAU - Young, Winston
AU  - Young W
FAU - Sloan, Sheldon
AU  - Sloan S
FAU - Robinson, Malcolm
AU  - Robinson M
FAU - Miner, Philip B Jr
AU  - Miner PB Jr
FAU - Gardner, Jerry D
AU  - Gardner JD
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20080523
PL  - England
TA  - BMC Gastroenterol
JT  - BMC gastroenterology
JID - 100968547
RN  - 0 (2-Pyridinylmethylsulfinylbenzimidazoles)
RN  - 0 (Proton Pump Inhibitors)
RN  - 32828355LL (Rabeprazole)
RN  - KG60484QX9 (Omeprazole)
SB  - IM
MH  - 2-Pyridinylmethylsulfinylbenzimidazoles/therapeutic use
MH  - Circadian Rhythm/*physiology
MH  - Esophageal pH Monitoring
MH  - Esophagus/*physiopathology
MH  - Gastroesophageal Reflux/*complications/*drug therapy/*etiology/physiopathology
MH  - Humans
MH  - Hydrogen-Ion Concentration
MH  - Omeprazole/therapeutic use
MH  - Predictive Value of Tests
MH  - Prevalence
MH  - Proton Pump Inhibitors/*therapeutic use
MH  - Rabeprazole
MH  - Retrospective Studies
PMC - PMC2409349
EDAT- 2008/05/24 09:00
MHDA- 2008/06/21 09:00
PMCR- 2008/05/23
CRDT- 2008/05/24 09:00
PHST- 2008/01/08 00:00 [received]
PHST- 2008/05/23 00:00 [accepted]
PHST- 2008/05/24 09:00 [pubmed]
PHST- 2008/06/21 09:00 [medline]
PHST- 2008/05/24 09:00 [entrez]
PHST- 2008/05/23 00:00 [pmc-release]
AID - 1471-230X-8-15 [pii]
AID - 10.1186/1471-230X-8-15 [doi]
PST - epublish
SO  - BMC Gastroenterol. 2008 May 23;8:15. doi: 10.1186/1471-230X-8-15.