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. 1998 Nov;43(5):603–606. doi: 10.1136/gut.43.5.603

Effect of omeprazole 20 mg twice daily on duodenogastric and gastro-oesophageal bile reflux in Barrett's oesophagus

R Marshall 1, A Anggiansah 1, D Manifold 1, W Owen 1, W Owen 1
PMCID: PMC1727328  PMID: 9824338

Abstract

Background—Both acid and duodenal contents are thought to be responsible for the mucosal damage in Barrett's oesophagus, a condition often treated medically. However, little is known about the effect of omeprazole on duodenogastric reflux (DGR) and duodenogastro-oesophageal reflux (DGOR).
Aims—To study the effect of omeprazole 20 mg twice daily on DGR and DGOR, using the technique of ambulatory bilirubin monitoring.
Methods—Twenty three patients with Barrett's oesophagus underwent manometry followed by 24 hour oesophageal and gastric pH monitoring. In conjunction with pH monitoring, 11 patients (group 1) underwent oesophageal bilirubin monitoring and 12 patients (group 2) underwent gastric bilirubin monitoring, both before and during treatment with omeprazole 20 mg twice daily.
Results—In both groups there was a significant reduction in oesophageal acid (pH<4) reflux (p<0.005) and a significant increase in the time gastric pH was above 4 (p<0.005). In group 1, median total oesophageal bilirubin exposure was significantly reduced from 28.9% to 2.4% (p<0.005). In group 2, median total gastric bilirubin exposure was significantly reduced from 24.9% to 7.2% (p<0.005). 
Conclusions—Treatment of Barrett's oesophagus with omeprazole 20 mg twice daily results in a notable reduction in the exposure of the oesophagus to both acid and duodenal contents. In addition, delivery of duodenal contents to the upper gastric body is reduced. 



Keywords: bilirubin monitoring; Barrett's oesophagus; omeprazole; pH monitoring; duodenogastric reflux; duodenogastro-oesophageal reflux

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Figure 1 .

Figure 1

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Group 1 and 2 patients combined: individual oesophageal acid reflux times before and during omeprazole treatment. 


Figure 2 .

Figure 2

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Group 1: individual oesophageal bilirubin reflux times before and during omeprazole treatment. 


Figure 3 .

Figure 3

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Group 2: individual gastric bilirubin reflux times before and during omeprazole treatment. 


Selected References

These references are in PubMed. This may not be the complete list of references from this article.

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