Proton-pump inhibitors are effective at preventing the acid component of gastro-esophageal refluxate from entering the esophagus.
It is not clear whether proton-pump inhibitors prevent duodenogastro-esophageal reflux.
Drde Caestecker and colleagues from England measured esophageal exposure to duodenogastro-esophageal refluxate while on proton-pump inhibitors in patients with Barrett's esophagus.
The research team included 25 patients, of which 23 were male, with Barrett's oesophagus.
|60% had abnormal esophageal exposure to bile as measured by Bilitec 2000|
|Alimentary Pharmacology & Therapeutics|
The patients underwent 24 hour esophageal pH and Bilitec 2000 monitoring while on omeprazole 40 mg/day (n = 19) or omeprazole 60 mg/day (n = 6).
The investigators ensured that all patients underwent argon plasma ablation of their Barrett's epithelium as part of a clinical trial.
The researchers only carried out the Bilitec measurements after the ablation had been completed.
The team found that 80% of patients had a normal esophageal pH profile.
60% had abnormal esophageal exposure to bile as measured by Bilitec 2000.
The research team also noted that of the 20 patients who had a normal 24 hour esophageal pH profile, 11 had pathological exposure to bile in their esophagus.
Dr de Caestecker’s team concluded, “Complete acid suppression does not guarantee elimination of duodenogastro-esophageal reflux.”