title: Normalization of oesophageal pH does not guarantee control of duodenogastro-oesophageal reflux in Barrett's oesophagus.
abstract: BACKGROUND
  Proton-pump inhibitors are effective at preventing the acid component of gastro-oesophageal refluxate from entering the oesophagus. It is not clear whether proton-pump inhibitors prevent duodenogastro-oesophageal reflux.
  
  
  OBJECTIVE
  To measure oesophageal exposure to duodenogastro-oesophageal refluxate while on proton-pump inhibitors in patients with Barrett's oesophagus.
  
  
  METHODS
  Twenty-five patients (23 male) with Barrett's oesophagus underwent 24 h oesophageal pH and Bilitec 2000 monitoring while on omeprazole 40 mg/day (n = 19) or omeprazole 60 mg/day (n = 6). All patients were undergoing argon plasma ablation of their Barrett's epithelium as part of a clinical trial and the Bilitec measurements were only carried out after the ablation had been completed.
  
  
  RESULTS
  20 of 25 (80%) patients had a normal oesophageal pH profile. Fifteen of the 25 (60%) had abnormal oesophageal exposure to bile as measured by Bilitec 2000. Of the 20 patients who had a normal 24 h oesophageal pH profile, 11 (55%) had pathological exposure to bile in their oesophagus.
  
  
  CONCLUSIONS
  Complete acid suppression does not guarantee elimination of duodenogastro-oesophageal reflux.
authors.affiliation: Digestive Diseases Centre, University Hospitals of Leicester NHS Trust, Gwendolen Road, Leicester LE5 4PW, UK.
authors.forename: J A
authors.initials: JA
authors.lastname: Todd
authors.forename: K K
authors.initials: KK
authors.lastname: Basu
authors.forename: J S
authors.initials: JS
authors.lastname: de Caestecker
mesh_terms: D000368:Aged; D000897:Anti-Ulcer Agents / Q000627:therapeutic use*; D001471:Barrett Esophagus / Q000150:complications*; D004378:Duodenal Diseases / Q000188:drug therapy*; D004945:Esophagoscopy; D004947:Esophagus / Q000502:physiology; D005260:Female; D005744:Gastric Acid / Q000502:physiology*; D005764:Gastroesophageal Reflux / Q000150:complications / Q000517:prevention & control*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D008875:Middle Aged; D009853:Omeprazole / Q000627:therapeutic use*; D054328:Proton Pump Inhibitors
chemical_list: D000897:Anti-Ulcer Agents; D054328:Proton Pump Inhibitors; D009853:Omeprazole