title: Impact of acid inhibition on esophageal mucosal injury induced by low-dose aspirin.
abstract: OBJECTIVE
  Aspirin enjoys widespread use as an antithrombotic drug, but such ubiquity also increases the risk of gastrointestinal mucosal injury. Recent studies have shown that aspirin can also induce esophageal mucosal injury. We resolved to determine the intragastric pH value necessary to prevent aspirin-induced esophageal mucosal injury.
  
  
  METHODS
  15 healthy Japanese volunteers were dosed for 7 days in a four-way random crossover trial with 100 mg entero-coated type aspirin only once daily, 100 mg aspirin + 20 mg famotidine twice daily, 15 mg lansoprazole once daily, or 10 mg rabeprazole once daily. All subjects underwent endoscopy and intragastric pH monitoring on day 7.
  
  
  RESULTS
  7 individuals (46.7%) developed esophageal mucosal injury when ingesting aspirin alone. The incidence of esophageal mucosal injury was reduced however with concomitant dosing of aspirin and famotidine (26.6%; p = 0.193), lansoprazole (0%; p = 0.004), and rabeprazole (6.7%; p = 0.019). Among individuals for whom mean 24-h pH was >5.0 and who experienced pH <4.0 less than 40% of the time, none developed aspirin-induced esophageal mucosal injury.
  
  
  CONCLUSIONS
  Acid inhibition achieved with a half-dose of a proton pump inhibitor effectively prevented development of aspirin-induced esophageal mucosal injury, whereas a standard dose of a histamine-2-receptor antagonist failed to achieve the same results.
authors: Center for Clinical Research, Hamamatsu University School of Medicine, Shizuoka, Japan. mitsu@hama-med.ac.jp
authors: Mitsushige
authors: M
authors: Sugimoto
authors: Masafumi
authors: M
authors: Nishino
authors: Chise
authors: C
authors: Kodaira
authors: Mihoko
authors: M
authors: Yamade
authors: Takahiro
authors: T
authors: Uotani
authors: Mutsuhiro
authors: M
authors: Ikuma
authors: Takahisa
authors: T
authors: Furuta
mesh_terms: D053799:2-Pyridinylmethylsulfinylbenzimidazoles / Q000494:pharmacology; D001241:Aspirin / Q000494:pharmacology*; D018592:Cross-Over Studies; D004947:Esophagus / Q000187:drug effects / Q000502:physiology; D015738:Famotidine / Q000494:pharmacology; D005260:Female; D005744:Gastric Acid / Q000502:physiology; D005745:Gastric Acidity Determination; D005764:Gastroesophageal Reflux / Q000503:physiopathology / Q000517:prevention & control*; D005773:Gastroscopy; D006801:Humans; D064747:Lansoprazole; D008297:Male; D009092:Mucous Membrane / Q000187:drug effects / Q000502:physiology; D010975:Platelet Aggregation Inhibitors / Q000494:pharmacology*; D054328:Proton Pump Inhibitors / Q000494:pharmacology*; D064750:Rabeprazole; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D010975:Platelet Aggregation Inhibitors; D054328:Proton Pump Inhibitors; D064747:Lansoprazole; D064750:Rabeprazole; D015738:Famotidine; D001241:Aspirin