PPI’S effectiveness in H.pylori eradication schemes depends on the basal secretion of hydrochloric acid

Abstract

Objective: Sufficient inhibition of HCl secretion is one way to improve the Helicobacter pylori (HP) eradication. The aim of the study was to evaluate PPI effectiveness at first day of treatment depending on the HCl basal secretion. Patients and Methods: We analyzed 83 results of 24-h-gastro-pH-monitoring at day one of PPI taking in patients with acid-dependent gastroesophageal diseases. Primarily we performed express-gastro-pH-monitoring. The separation criterion was established previously by express-gastro-pH-monitoring indicators (Х pH >2.48 units, Me pH >2.3 units, Mo pН >2.35 units). We created two groups comparable by age, sex, height, weight, and prescribed PPI. Group I – 55 patients with indicators less than suggested. Group II – 28 patients with indicators corresponding to the proposed criteria. We studied 24-h-gastro-pH-monitoring pH indicators (X pH, Me pH, Mo pH) for basal period-time from the start of the investigation to the first PPI dose (1 hour); time after the first PPI dose until the end of monitoring (23 h); night period (22:00-07:00). Results: The basal period intragastric indicators X pH, Me pH, Mo pH in I group were significantly (p<0.01) lower (1.9±0.09, 1.75±0.07, 1.68±0.07 vs. 2.2±0.09, 2.03±0.1, 1.96±0.1). 23 hours after the first PPI dose in group I indicators were significantly (p<0.01) lower (4.2±0.2, 4.07±0.2, 3.6±0.2 vs. 4.9±0.2, 4.9±0.3, 4.5±0.3); night period indicators in the group I were significantly (p<0.01) lower (4.3±0.2, 4.2±0.3, 3, 9±0.3 vs. 5.03±0.2, 5.02±0.3, 4.9±0.4). Conclusions: Basal gastric acidity affects PPI acid-blocking action at the first day of treatment during the 23-hour period and night period. The proposed criteria for prognostic PPI acid-blocking effect assessment before treatment are sufficient.