Study on nocturnal acid breakthrough in patients with gastroesophageal reflux

Objective To assess the incidence of nocturnal acid breakthrough(NAB) and its relationship with esophageal acid exposure and Hp infection in patients with gastroesophageal reflux(GER).Methods Fifty-two GER patients were randomly allocated into two groups.The patients were treated with esomeprazole 40 mg twice daily orally and omeprazole 40 mg twice and ranitidine 150 mg once daily.Intragastric pH over 24 hours was recorded on the eighth day and esophageal symptom scores were evaluated for each patients.Results In comparison with that in two groups,intragastric pH was higher in after than that in before treatment,respectively.The percentage of fraction time of pH below 4.0 in group esomeprazole was much lower than that in group esomeprazole plus ranitidine.The incideuce of NAB in group esomeprazole(34.5%) was significantly higher(P0.05)and symptom scores were greatly improved in groups esomeprazole plus ranitidine.The incidence of NAB in Hp negative patients(55.6%) was significantly higher than that in Hp positive patients(20.5%,P0.05).Conclusion NAB occurred less common in Chinese patients with GER than patients in western countries. Acid reflux and symptoms in patients with GER do not dependence NAB status.Hp infection are closely related to the incidence of NAB.