Little necessity of acid inhibition against proton pump inhibitor rebound effects and prior helicobacter pylori eradication therapy in gastric ulcer patients: a randomized prospective study.
OBJECTIVE
Helicobacter pylori (H. pylori) eradication therapy increases acid secretion and promotes the development of gastroesophageal reflux disease (GERD) and reflux esophagitis (RE). Rebound acid hypersecretion develops after the use of proton pump inhibitors (PPI). We examined the clinical necessity of acid inhibitors to prevent GERD or RE caused by PPI rebound phenomenon and prior H. pylori eradication therapy.


METHODS
We enrolled 39 patients who underwent successful H. pylori eradication therapy prior to endoscopic mucosal resection of gastric cancer. After 8-week rabeprazole treatment for iatrogenic ulcer, they were randomly divided into two groups (who took nizatidine (group N) and sofalcone (group S)), and took each for 16 weeks, we compared RE/GERD symptoms with the baseline by endoscopy and QUEST score.


RESULTS
All patients had corpus atrophy in which there was no difference between the two groups. Only 1 patient in group S (5.9%) developed symptomatic GERD, and 1 patient in group N (4.5%) developed RE.


CONCLUSIONS
In severe atrophic gastritis patients, there is little clinical necessity of acid inhibitors to prevent GERD/RE caused by PPI rebound and prior H. pylori eradication therapy.
Wada
Yoshihiro
Y
Department of Medicine and Molecular Science, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan.
Ito
Masanori
M
Takata
Shunsuke
S
Kitamura
Shosuke
S
Takamura
Akemi
A
Tatsugami
Masana
M
Imagawa
Shinobu
S
Matsumoto
Yoshiaki
Y
Tanaka
Shinji
S
Yoshihara
Masaharu
M
Chayama
Kazuaki
K
D053799:2-Pyridinylmethylsulfinylbenzimidazoles / Q000009:adverse effects; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000897:Anti-Ulcer Agents / Q000627:therapeutic use*; D047188:Chalcones / Q000627:therapeutic use*; D015331:Cohort Studies; D004942:Esophagitis, Peptic / Q000209:etiology / Q000473:pathology / Q000517:prevention & control*; D005764:Gastroesophageal Reflux / Q000209:etiology / Q000473:pathology / Q000517:prevention & control*; D016481:Helicobacter Infections / Q000628:therapy; D016480:Helicobacter pylori; D006801:Humans; D008875:Middle Aged; D016567:Nizatidine / Q000627:therapeutic use*; D054328:Proton Pump Inhibitors / Q000009:adverse effects*; D064750:Rabeprazole; D013274:Stomach Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery; D013276:Stomach Ulcer / Q000188:drug therapy / Q000209:etiology / Q000473:pathology
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000897:Anti-Ulcer Agents; D047188:Chalcones; D054328:Proton Pump Inhibitors; C035032:sofalcone; D064750:Rabeprazole; D016567:Nizatidine