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Time pattern of gastric acidity in Barrett's esophagus

  • Esophageal, Gastric, And Duodenal Disorders
  • Published:
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Abstract

Increased gastroesophageal acid reflux is frequently found in patients with Barrett's esophagus, and it has been hypothesized that gastric acid hypersecretion could be an important factor aggravating the exposure of esophageal mucosa to acid and then contributing to the development of this disorder. The aim of the present study was to assess whether the circadian pattern of gastric acidity differs between refluxer patients with and without Barrett's esophagus and normal subjects. Continuous 24-hr gastric pH monitoring was performed in 119 healthy volunteers, 20 patients with Barrett's esophagus, 37 patients with moderate and 10 patients with severe reflux esophagitis without Barrett's esophagus. In all these diseases the final diagnosis was ascertained by means of endoscopy plus biopsy. There was no difference in the 24-hr and daytime patterns of gastric pH between healthy subjects and patients with Barrett's esophagus, while nocturnal acidity was significantly lower (P<0.05) in the latter population. Gastric acidity, in contrast, was higher (P<0.05) in controls than in patients with both moderate and severe reflux esophagitis without Barrett's esophagus during the whole 24-hr period. There was no difference between refluxer patients with and without Barrett's esophagus in any of the three time intervals we analyzed. Because normal subjects had lower gastric pH than patients with Barrett's esophagus during the night and than patients with reflux esophagitis during the whole 24-hr period, gastric hyperacidity is not a relevant factor in the development of both metaplastic columnar epithelium and inflammatory changes in the distal esophagus, and other pathophysiological mechanisms are involved in these histological alterations.

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Authors and Affiliations

  1. From the Dipartimento di Medicina Interna, Cattedra di Gastroenterologia and Istituto di Anatomia Pathologica, Università di Genova, Italy

    Vincenzo Savarino MD, Giuseppe Sandro Mela MD, Patrizia Zentilin MD, Maria Raffaella Mele MD, Carlo Mansi MD, Anna Carla Remagnino MD, Sergio Vigneri MD, Alberto Malesci MD, Monica Belicchi MD, Gabriella Lapertosa MD & Guido Celle MD

  2. Istituto di Anatomia Patologica, Università di Genova, Italy

    Vincenzo Savarino MD, Giuseppe Sandro Mela MD, Patrizia Zentilin MD, Maria Raffaella Mele MD, Carlo Mansi MD, Anna Carla Remagnino MD, Sergio Vigneri MD, Alberto Malesci MD, Monica Belicchi MD, Gabriella Lapertosa MD & Guido Celle MD

  3. Istituto di Medicina Interna e Geriatria, Università di Palermo, Italy

    Vincenzo Savarino MD, Giuseppe Sandro Mela MD, Patrizia Zentilin MD, Maria Raffaella Mele MD, Carlo Mansi MD, Anna Carla Remagnino MD, Sergio Vigneri MD, Alberto Malesci MD, Monica Belicchi MD, Gabriella Lapertosa MD & Guido Celle MD

Authors
  1. Vincenzo Savarino MD
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  2. Giuseppe Sandro Mela MD
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  3. Patrizia Zentilin MD
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  4. Maria Raffaella Mele MD
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  5. Carlo Mansi MD
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  6. Anna Carla Remagnino MD
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  7. Sergio Vigneri MD
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  8. Alberto Malesci MD
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  9. Monica Belicchi MD
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  10. Gabriella Lapertosa MD
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  11. Guido Celle MD
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Savarino, V., Mela, G.S., Zentilin, P. et al. Time pattern of gastric acidity in Barrett's esophagus. Digest Dis Sci 41, 1379–1383 (1996). https://doi.org/10.1007/BF02088562

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  • DOI: https://doi.org/10.1007/BF02088562

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