Nocturnal recovery of gastric acid secretion with twice-daily dosing of proton pump inhibitors.
OBJECTIVE
It is our experience that many patients treated with proton pump inhibitors (PPI) b.i.d. recover acid secretion during the night. Our aim was to assess the efficacy of omeprazole and lansoprazole b.i.d. on nocturnal gastric acidity.


METHODS
Three groups were studied with intragastric pH monitoring. Group 1 consisted of 17 patients with gastroesophageal reflux disease (GERD) taking omeprazole 20 mg b.i.d. Group 2 was 16 male volunteers taking omeprazole 20 mg b.i.d. and Group 3 comprised 12 volunteers taking lansoprazole 30 mg b.i.d.


RESULTS
The percentages of time that subjects had pH < 4 were lower during supine than upright periods in Groups 1 and 3 (P < 0.01). Recovery of nocturnal acid secretion lasting > 1 h, termed acid breakthrough, occurred in three-fourths of all individuals within 12 h from intake of the evening dose of PPI. Median time to acid breakthrough for the whole group was 7.5 h.


CONCLUSIONS
Nocturnal acid breakthrough occurs in a majority of patients and normal volunteers taking PPI b.i.d.
Peghini
P L
PL
The Esophageal Research Laboratory, Allegheny University Hospitals, Graduate, Philadelphia, Pennsylvania 19146, USA.
Katz
P O
PO
Bracy
N A
NA
Castell
D O
DO
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000328:Adult; D000368:Aged; D000897:Anti-Ulcer Agents / Q000627:therapeutic use*; D002940:Circadian Rhythm; D005260:Female; D005744:Gastric Acid / Q000378:metabolism*; D005745:Gastric Acidity Determination; D005764:Gastroesophageal Reflux / Q000188:drug therapy / Q000503:physiopathology*; D006801:Humans; D064747:Lansoprazole; D008297:Male; D008875:Middle Aged; D018670:Monitoring, Ambulatory; D009853:Omeprazole / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D054328:Proton Pump Inhibitors
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000897:Anti-Ulcer Agents; D054328:Proton Pump Inhibitors; D064747:Lansoprazole; D009853:Omeprazole