Efficacy in intra-oesophageal acid suppression may decrease after 2-year continuous treatment with proton pump inhibitors

M. Frazzoni, M. Manno, E. De Micheli, V. Savarino

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Long-term intra-oesophageal acid suppression with proton pump inhibitors represents a management option for Barrett's oesophagus and severe reflux oesophagitis, but its stability over time has not been adequately assessed. Aim: Our aim was to evaluate prospectively the efficacy of proton pump inhibitors in suppressing intra-oesophageal acidity after 2-year continuous treatment. Methods: Forty-five patients with Barrett's oesophagus or severe reflux oesophagitis on a proton pump inhibitor regimen (once or twice daily) that normalised the total percentage acid exposure time were re-evaluated by means of 24-h oesophageal pH-monitoring after 2-year of continuous unmodified treatment. Results: A significant rise in the total percentage acid exposure time was observed at 2-year follow-up (P = 0.029), owing to an increased value in 27 (60%) cases (9 on a twice daily regimen), higher than normal in 10 of them (22% of the whole group) (3 on a twice daily regimen). In 18 patients (40%) the total percentage acid exposure time was stable or decreased. Heartburn remained efficiently suppressed in all patients. Conclusions: The efficacy of proton pump inhibitors in suppressing intra-oesophageal acidity during continuous treatment may decrease over time, up to abnormal levels of oesophageal acid exposure in a minority of cases. This may occur without heartburn recurrence and with both once and twice daily regimens.

Original languageEnglish
Pages (from-to)415-421
Number of pages7
JournalDigestive and Liver Disease
Volume39
Issue number5
DOIs
Publication statusPublished - May 2007

Keywords

  • Gastro-oesophageal reflux disease
  • Proton pump inhibitors

ASJC Scopus subject areas

  • Gastroenterology

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