Document Detail


The influence of feeding on gastric acid suppression in Helicobacter pylori-positive patients treated with a proton pump inhibitor or an H2-receptor antagonist after bleeding from a gastric ulcer.
MedLine Citation:
PMID:  14564629     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: This study investigated the influence of feeding on gastric acid suppression in Helicobacter pylori-positive patients treated with intravenous infusions of proton pump inhibitors (PPIs) or with H2-receptor antagonists (H2-RAs) after bleeding from a gastric ulcer. METHODS: Forty-nine H. pylori-positive patients with bleeding gastric ulcers (44 men and 5 women) were divided into four groups: one group received an H2-RA while fasting, one group received an H2-RA while eating regularly, one group received a PPI while fasting, and one group received a PPI while eating regularly. Intragastric pH was monitored during fasting and nonfasting to calculate the pH 3 and pH 4 holding times and the mean pH. RESULTS: During a 24-h fast, the pH 3 and pH 4 holding times and the mean pH were significantly higher in patients administered omeprazole (PPI; 93.2 +/- 9.2%, 90.6 +/- 11.1%, and 6.9 +/- 0.6, respectively) than in those administered ranitidine (H2-RA; 61.0 +/- 27.5%, 55.8 +/- 29.1%, and 4.8 +/- 1.3, respectively; P<0.001 for all). Results were similar during feeding (PPI meal, 98.9 +/- 2.6%, 98.3 +/- 3.7%, and 6.9 +/- 0.3; H2-RA meal, 59.8 +/- 17.6%, 49.7 +/- 18.0%, and 4.3 +/- 0.7, respectively; P<0.001 for all). In addition, the pH 3 and pH 4 holding times and the mean pH in the H2-RA meal group were not significantly lower than those in the H2-RA group (P=0.999, P=0.865, and P=0.687, respectively). The values in the PPI and PPI meal groups were similar (P=0.872, P=0.777, and P>0.999, respectively). CONCLUSIONS: Gastric acid suppression during the administration of an H2-RA or a PPI soon after the cessation of gastric bleeding was scarcely affected by feeding. It may well be that H. pylori-positive patients with bleeding gastric ulcer can resume a regular diet and return to work soon after bleeding ceases.
Authors:
Tatsuo Ozawa; Nozomi Yoshikawa; Takashige Tomita; Yasushi Akita; Keiji Mitamura
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Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  Journal of gastroenterology     Volume:  38     ISSN:  0944-1174     ISO Abbreviation:  J. Gastroenterol.     Publication Date:  2003  
Date Detail:
Created Date:  2003-10-17     Completed Date:  2004-03-02     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9430794     Medline TA:  J Gastroenterol     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  844-8     Citation Subset:  IM    
Affiliation:
Second Department of Internal Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8666, Japan.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Eating / physiology*
Fasting / physiology
Female
Gastric Acid / secretion*
Helicobacter pylori*
Histamine H2 Antagonists / administration & dosage*
Humans
Infusions, Intravenous
Male
Middle Aged
Peptic Ulcer Hemorrhage / microbiology,  physiopathology*,  therapy
Proton Pumps / administration & dosage*,  antagonists & inhibitors*
Stomach Ulcer / complications,  physiopathology
Chemical
Reg. No./Substance:
0/Histamine H2 Antagonists; 0/Proton Pumps

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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