Effect of Helicobacter pylori status on intragastric pH during treatment with omeprazole.
ABSTRACT To test the hypothesis that Helicobacter pylori infection is associated with a decreased intragastric acidity during omeprazole therapy, ambulatory 24 hour dual point gastric pH recordings were performed in 18 H pylori positive and 14 H pylori negative subjects. There was a four to six week washout period between the two pH recordings made in each subject after one week courses of placebo or omeprazole, 20 mg daily. During placebo, median 24 hour pH values were not different in the corpus (H pylori positive = 1.5, negative = 1.4; p = 0.9) or antrum (H pylori positive = 1.3, negative = 1.2; p = 0.1). However, during omeprazole treatment, median 24 hour pH values were higher in H pylori positive subjects, both in the corpus (H pylori positive = 5.5, negative = 4.0; p = 0.001) and antrum (H pylori positive = 5.5, negative = 3.5; p = 0.0004). During placebo treatment, the only difference between the two groups was a higher later nocturnal pH in the antrum in the H pylori positive group. During omeprazole treatment, gastric pH was higher both in the corpus and in the antrum in the H pylori positive group for all periods, except for mealtime in the corpus. These data indicate that omeprazole produces a greater decrease in gastric acidity in subjects with H pylori infection than in those who are H pylori negative. It is not, however, known whether there is a causal relationship between H pylori infection and increased omeprazole efficacy.
Full-textDOI: · Available from: David Armstrong, May 29, 2015
SourceAvailable from: Gulzar Alam
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ABSTRACT: This study was conducted to evaluate the influence H. pylori infection and anti-CagA status on the efficacy of Omeperazole 20 m.g. b.d. for patients with endoscopic oesophagitis. The influence of Helicobacter pylori (H. pylori) infection and its virulent strain (cytotoxin-associated gene A: CagA) has not been evaluated on efficacy of treatment for patients with erosive oesophagitis in Iran. One hundred and ten patients (55 H. Pylori positive and 55 H. Pylori negative) with endoscopic evidence of oeosphagitis were enrolled in this interventional study and treated with Omeprazole 20 m.g. b.d. Healing was assessed at repeat endoscopy after 8 weeks of treatment. H. Pylori infection and anti-CagA-IgG (immunoglobulin G) antibodies were determined for each subject by the rapid urease test, pathological assessment and ELISA. At repeat endoscopy, following 8 weeks of Omeprazole 20 m.g. b.d. therapy, endoscopic healing of oesophagitis had occurred in 32 % of the HP +ve patients and 23 % of the HP -ve patients (chi square p < 0.01). Among the HP +ve endoscopic healing occurred resolved in 11 (32.4 %) of the CagA +ve patients and 19 (90.5 %) of the CagA -ve patients. This difference was significant (chi-square p <0.001). H. pylori infection and the CagA virulence factor are associated with an increased rate of healing amongst patients with endoscopic oesophagitis treated with Omperazole 20 m.g. b.d. compared to patients without H. pylori infection.01/2013; 6(Suppl 1):S93-8.
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ABSTRACT: Reasons for performing the study A recent study suggested that the duration of acid suppression achieved with once-daily administration of omeprazole is as short as 12h and that administration of omeprazole prior to exercise may be superior compared with administration at other times of the day in the treatment of equine gastric ulcer syndrome (EGUS). Objectives The primary objective of the study was to investigate whether the administration of omeprazole prior to exercise resulted in better healing of EGUS compared with administration post exercise. A secondary objective was to investigate the differences between the response of squamous and glandular EGUS to omeprazole therapy. Study design A randomised, blinded, clinical trial. Methods Twenty-five horses with grade 2/4 squamous EGUS were identified by gastroscopy. The glandular mucosa was also scored. Horses were randomly assigned to receive 4.0mg/kg bwt of omeprazole per os once daily either 1-4h prior to high-intensity exercise (PRE group; 13 horses) or 1-4h after exercise (POST group; 12 horses). Gastroscopy was repeated at approximately 25 days. Results No differences were observed between the pre- and post exercise treatment groups. Overall, healing was observed in 80% of squamous ulcers vs. 21% of glandular ulcers (P = 0.0002), and improvement was seen in 96% of squamous ulcers vs. 53% of glandular ulcers (P = 0.001). Worsening was observed in the glandular mucosa of 13% of horses. Conclusions The results of this study suggest that the timing of administration does not affect ulcer healing. Furthermore, the study demonstrates that the response of glandular ulceration to omeprazole therapy is inferior to that of the squamous mucosa.Equine Veterinary Journal 07/2014; 46(4). DOI:10.1111/evj.12083 · 2.37 Impact Factor