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The effect of rabeprazole on regional gastric acidity and the postprandial cardia/gastro‐oesophageal junction acid layer in normal subjects: a randomized, double‐blind, placebo‐controlled study

2005; Wiley; Volume: 21; Issue: 11 Linguagem: Inglês

10.1111/j.1365-2036.2005.02489.x

1365-2036

L. Vo, Hrair P. Simonian, Siva Doma, Robert S. Fisher, Henry P. Parkman,

Esophageal and GI Pathology

Summary Background : Postprandial intragastric acidity is not uniform. Postprandial proximal gastric acid pockets have been described in the present study. Aim : To determine the effects of rabeprazole on regional intragastric acidity and proximal acid pockets. Methods : Ten normal subjects underwent two 8‐day oral dosing regimens with placebo or rabeprazole 20 mg each morning in a randomized, double‐blind protocol. Oesophago‐gastric pH monitoring was performed on days 1 and 8. Results : Rabeprazole increased fasting and postprandial gastric pH to above 4 in each area of the stomach on days 1 and 8. With placebo, acid pockets were identified at the cardia/gastro‐oesophageal junction in 62 and 50 of 150 pull‐throughs on days 1 and 8, respectively. Acid pockets were detected postprandially 3.1 ± 0.2–5.8 ± 0.1 cm below the proximal border of the lower oesophageal sphincter with a mean pH drop from 4.6 ± 0.1 to 1.5 ± 0.1. Rabeprazole decreased the number of acid pockets to 30 and 27 on days 1 and 8, respectively. Rabeprazole also decreased their length and magnitude of the pH drop. Conclusions : Rabeprazole increased intragastric pH on day 1 and 8 and maintained an elevated pH during and after meals. Postprandial acid pockets, identified in the region of the cardia/gastro‐oesophageal junction area postprandially, were decreased in number, length and magnitude by rabeprazole.