Circadian pattern of intragastric acidity in patients with non-erosive reflux disease (NERD)
Article first published online: 4 FEB 2003
Alimentary Pharmacology & Therapeutics
Volume 17, Issue 3, pages 353–359, February 2003
How to Cite
Zentilin, P., Dulbecco, P., Bilardi, C., Gambaro, C., Iiritano, E., Biagini, R., Mela, G. S., Tessieri, L., Mele, M. R., Mansi, C., Pandolfo, N., Vigneri, S. and Savarino, V. (2003), Circadian pattern of intragastric acidity in patients with non-erosive reflux disease (NERD). Alimentary Pharmacology & Therapeutics, 17: 353–359. doi: 10.1046/j.1365-2036.2003.01422.x
- Issue published online: 4 FEB 2003
- Article first published online: 4 FEB 2003
- Accepted for publication 29 October 2002
Background : Most patients with gastro-oesophageal reflux disease have non-erosive reflux disease. Proton pump inhibitors are less effective than expected in these patients, but no previous study has measured their 24-h gastric pH values.
Aims : To evaluate whether there are differences in 24-h intragastric acidity between reflux patients with and without oesophagitis and controls. The influence of Helicobacter pylori on the gastric pH of reflux patients was also assessed.
Methods : Sixty-three consecutive patients with gastro-oesophageal reflux disease symptoms who agreed to undergo endoscopy and 24-h pH-metry were recruited. Twenty-five (39%) had erosive oesophagitis and 38 (61%) did not. H. pylori was diagnosed by CLO test, histology and 13C-urea breath test. Gastric pH was also measured in 30 controls without digestive symptoms.
Results : H. pylori was found in seven of the 25 (28%) patients with oesophagitis and 14 of the 38 (37%) patients with non-erosive reflux disease. Oesophageal pH-metry was abnormal in 21 of the 25 (84%) patients with oesophagitis and in 32 of the 38 (84%) patients with non-erosive reflux disease. The median gastric pH did not differ between patients with and without oesophagitis or between them and controls during the 24 h (P = 0.8) and other time intervals (P = 0.2–0.4). The gastric pH did not differ between infected and non-infected patients with oesophagitis (P = 0.2–0.4) or non-erosive reflux disease (P = 0.3–0.8).
Conclusions : The circadian pattern of intragastric acidity does not differ between patients with non-erosive reflux disease and oesophagitis. Moreover, the study confirms that H. pylori infection does not affect the gastric pH in either group of reflux patients.