The effect of eight weeks of rabeprazole therapy on nitric oxide plasma level and esophageal pH and motility and motility nitric oxide plasma level in patients with erosive esophagitis.
BACKGROUND
Esophageal clearance, an important pathogenetic factor in gastroesophageal reflux disease, depends mainly on motility. Motility disturbances can be secondary to gastric output reflux. Nitric oxide influences esophageal motility. The aim of this study was to determine the effect of eight weeks of gastric acid secretion suppression with rabeprazole (20 mg/day) on esophageal motility.


METHODS
20 patients with erosive esophagitis were studied. At study start and two weeks after the end of therapy, we recorded the results of interview, endoscopy, gastric and esophageal mucosa biopsy, 24-h esophageal pH-metry and manometry, and NO metabolites plasma concentration, determined spectrophotometrically (OXIS).


RESULTS
All patients reported improvement and remained free of symptoms two weeks later. In 60% of cases, improvement of esophageal mucosa appearance was observed in endoscopic and histological examination. In follow-up we found a significantly smaller number of acid gastrooesophageal refluxes (p<0.05), reduced DeMeester score for pH range >7 (p<0.05), and greater % of time within the esophageal pH range 6-7 (p<0.05). Other esophageal pH-metry and 24-h manometry parameters did not change significantly. NO metabolites plasma concentration increased significantly (p=0.039).


CONCLUSIONS
Clinical improvement after eight weeks of therapy with rabeprazole was connected with endoscopic changes only in 60% of our patients. Rabeprazole therapy did not influence esophageal motility, despite increased plasma levels of NO metabolites. Patients with erosive esophagitis need maintenance therapy, since as soon as two weeks after the end of treatment the % of monitoring time with esophageal pH<4 was similar to study start.
Swiatkowski
Maciej
M
Department of Gastroenterology, Vascular Diseases and Internal Medicine, Ludwik Rydygier Medical University, 75 Ujejskiego Street, 85-168 Bydgoszcz, Poland.
Budzyński
Jacek
J
Kłopocka
Maria
M
Grad
Krzysztof
K
Pulkowski
Grzegorz
G
Augustyńska
Beata
B
Suppan
Karol
K
Fabisiak
Jacek
J
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000328:Adult; D000897:Anti-Ulcer Agents / Q000627:therapeutic use*; D001562:Benzimidazoles / Q000627:therapeutic use*; D004942:Esophagitis, Peptic / Q000097:blood / Q000188:drug therapy* / Q000378:metabolism / Q000503:physiopathology; D004947:Esophagus / Q000378:metabolism / Q000503:physiopathology*; D005260:Female; D005769:Gastrointestinal Motility / Q000187:drug effects; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D008365:Manometry; D008875:Middle Aged; D018670:Monitoring, Ambulatory; D009569:Nitric Oxide / Q000097:blood*; D009573:Nitrites / Q000097:blood; D009853:Omeprazole / Q000031:analogs & derivatives; D064750:Rabeprazole; D013997:Time Factors
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000897:Anti-Ulcer Agents; D001562:Benzimidazoles; D009573:Nitrites; D009569:Nitric Oxide; D064750:Rabeprazole; D009853:Omeprazole