PMID- 7594345
OWN - NLM
STAT- MEDLINE
DCOM- 19951212
LR  - 20190817
IS  - 0192-0790 (Print)
IS  - 0192-0790 (Linking)
VI  - 20 Suppl 2
DP  - 1995
TI  - Clinical study on the pathophysiology and treatment of PPI-resistant ulcers.
PG  - S67-71
AB  - We studied the gastric acidity, gastric emptying, and proton pump inhibitor (PPI) 
      plasma levels in 10 patients with PPI-resistant ulcers. The pH3 holding-time 
      ratio was low in nine of these patients, with an average ratio of only 39%. PPI 
      plasma levels in those patients were also much lower than in those with 
      nonresistant ulcers. Gastric emptying, determined by the acetaminophen method, 
      was reduced in all 10 patients. Therefore, PPI-resistant ulcers appear to result 
      from insufficient inhibition of gastric acidity, with reduced gastric emptying 
      interfering with the absorption of PPIs. In patients with mild reductions in 
      gastric emptying, PPI plasma levels increased after a change from single-unit 
      enteric-coated tablets (omeprazole) to multiunit enteric-coated granules in 
      capsules (lansoprazole). This change in formulation markedly inhibited gastric 
      acidity and led to rapid healing. In patients with moderate reductions in gastric 
      emptying, doubling the dose of lansoprazole was effective. In patients with 
      severely reduced gastric emptying, there appeared to be a limit to the 
      effectiveness of oral administration of PPIs. Changing the formulation and 
      doubling the dose to compensate for reduced gastric emptying are effective 
      approaches in the treatment of patients with PPI-resistant ulcers.
FAU - Ashida, K
AU  - Ashida K
AD  - Second Department of Internal Medicine, Osaka Medical College, Takatsuki, Japan.
FAU - Sakaguchi, M
AU  - Sakaguchi M
FAU - Tanaka, M
AU  - Tanaka M
FAU - Takiuchi, H
AU  - Takiuchi H
FAU - Egashira, Y
AU  - Egashira Y
FAU - Katsu, K
AU  - Katsu K
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - United States
TA  - J Clin Gastroenterol
JT  - Journal of clinical gastroenterology
JID - 7910017
RN  - 0 (2-Pyridinylmethylsulfinylbenzimidazoles)
RN  - 0 (Anti-Ulcer Agents)
RN  - 0 (Proton Pump Inhibitors)
RN  - 0K5C5T2QPG (Lansoprazole)
RN  - KG60484QX9 (Omeprazole)
SB  - IM
MH  - 2-Pyridinylmethylsulfinylbenzimidazoles
MH  - Anti-Ulcer Agents/*therapeutic use
MH  - Drug Resistance
MH  - Duodenal Ulcer/drug therapy/physiopathology
MH  - Gastric Acid/metabolism
MH  - Gastric Emptying
MH  - Humans
MH  - Hydrogen-Ion Concentration
MH  - Lansoprazole
MH  - Omeprazole/administration & dosage/analogs & 
      derivatives/pharmacokinetics/therapeutic use
MH  - Peptic Ulcer/*drug therapy/*physiopathology
MH  - *Proton Pump Inhibitors
MH  - Stomach Ulcer/drug therapy/physiopathology
EDAT- 1995/01/01 00:00
MHDA- 1995/01/01 00:01
CRDT- 1995/01/01 00:00
PHST- 1995/01/01 00:00 [pubmed]
PHST- 1995/01/01 00:01 [medline]
PHST- 1995/01/01 00:00 [entrez]
AID - 10.1097/00004836-199506002-00018 [doi]
PST - ppublish
SO  - J Clin Gastroenterol. 1995;20 Suppl 2:S67-71. doi: 
      10.1097/00004836-199506002-00018.