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Nocturnal acid breakthrough on proton pump inhibitor therapy: To treat or not to treat

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Opinion statement

Nocturnal acid breakthrough is misunderstood and infrequently requires treatment in everyday practice. There are important subgroups of patients in whom esophageal reflux occurs in the presence of nocturnal acid breakthrough in which treatment may be needed.

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References and Recommended Reading

  1. Peghini PL, Katz PO, Bracy NA, Castell DO: Nocturnal recovery of gastric acid secretion with twice daily dosing of proton pump inhibitors. Am J Gastroenterol 1998, 93:763–767.

    Article  PubMed  CAS  Google Scholar 

  2. Katz PO, Anderson C, Khoury R, Castell DO: Gastrooesophageal reflux associated with nocturnal gastric acid breakthrough on proton pump inhibitors. Aliment Pharmacol Ther 1998, 12:1231–1234.

    Article  PubMed  CAS  Google Scholar 

  3. Fouad YM, Katz PO, Castell DO: Oesophageal motility defects associated with nocturnal gastro-oesophageal reflux on proton pump inhibitors. Aliment Pharmacol Ther 1999, 13:1467–1471.

    Article  PubMed  CAS  Google Scholar 

  4. Johnson DA, Stacy T, Ryan M, et al.: A comparison of esomeprazole and lansoprazole for control of intragastric pH in patients with symptoms of gastro-oesophageal reflux disease. Aliment Pharmacol Ther 2005, 22:129–134.

    Article  PubMed  CAS  Google Scholar 

  5. Hammer J, Schmidt B: Effect of splitting the dose of esomeprazole on gastric acidity and nocturnal acid breakthrough. Aliment Pharmacol Ther 2004, 19:1105–1110.

    Article  PubMed  CAS  Google Scholar 

  6. Tutuian R, Katz PO, Castell DO: A PPI is a PPI is a PPI: lessons from prolonged intragastric pH monitoring [abstract]. Gastroenterology 2000, 118:A17.

    Article  Google Scholar 

  7. Martinek J, Pantoflickova D, Huci T, et al.: Absence of nocturnal acid breakthrough in Helicobacter pylori positive subjects treated with twice-daily omeprazole. Eur J Gastroenterol Hepatol 2004, 16:445–450.

    Article  PubMed  CAS  Google Scholar 

  8. Van Herwaarden MA, Samson M, Smout AJ: Helicobacter pylori eradication increases nocturnal acid breakthrough. Aliment Pharmacol Ther 2000, 14:961–962.

    Article  PubMed  Google Scholar 

  9. Katsube T, Adachi K, Kawamura A, et al.: Helicobacter pylori infection influences nocturnal acid breakthrough. Aliment Pharmacol Ther 2000, 14:1049–1056.

    Article  PubMed  CAS  Google Scholar 

  10. Ours TM, Fackler WK, Richter JE, Vaezi MF: Nocturnal acid breakthrough: clinical significance and correlation with esophageal acid exposure. Am J Gastroenterol 2003, 98:545–550.

    Article  PubMed  Google Scholar 

  11. El-Serag H, Aguirre T, Davis S, et al.: Proton pump inhibitors are associated with reduced incidence of dysplasia in Barrett’s esophagus. Am J Gastroenterol 2004, 99:1877–1883.

    Article  PubMed  CAS  Google Scholar 

  12. Khoury RM, Camacho-Lobato L, Katz PO, et al.: Influence of spontaneous sleep positions on nighttime recumbent reflux in patients with gastroesophageal reflux disease. Am J Gastroenterol 1999, 94:2069–2073.

    Article  PubMed  CAS  Google Scholar 

  13. Hatlebakk JG, Katz PO, Castell DO: Proton pump inhibitors: better acid suppression when taken before a meal than without a meal. Aliment Pharmacol Ther 2000, 14:1267–1272.

    Article  PubMed  CAS  Google Scholar 

  14. Hatlebakk JG, Katz PO, Kuo B, Castell DO: Nocturnal gastric acidity and acid breakthrough on different regimens of omeprazole 40 mg daily. Aliment Pharmacol Ther 1998, 12:1235–1240.

    Article  PubMed  CAS  Google Scholar 

  15. Peghini PL, Katz PO, Castell DO: Ranitidine controls nocturnal gastric acid breakthrough on omeprazole: a controlled study in normal subjects. Gastroenterology 1998, 115:1335–1339.

    Article  PubMed  CAS  Google Scholar 

  16. Fackler WK, Ours TM, Vaezi MF, Richter JE: Long-term effect of H2RA therapy on nocturnal gastric acid breakthrough. Gastroenterology 2002, 122:625–632.

    Article  PubMed  CAS  Google Scholar 

  17. Xue S, Katz PO, Banerjee P, et al.: Bedtime H2 blockers improve nocturnal gastric acid control in GERD patients on proton pump inhibitors. Aliment Pharmacol Ther 2001, 15:1351–1356.

    Article  PubMed  CAS  Google Scholar 

  18. Kuo B, Castell DO: Optimal dosing of omeprazole 40 mg daily: effects on gastric acid and esophageal pH and serum gastrin in healthy controls. Am J Gastroenterol 1996, 91:1532–1538.

    PubMed  CAS  Google Scholar 

  19. Khoury RM, Katz PO, Hammod R, et al.: Bedtime ranitidine does not eliminate the need for a second dose of omeprazole to suppress nocturnal gastric pH. Aliment Pharmacol Ther 1999, 13:675–678.

    Article  PubMed  CAS  Google Scholar 

  20. Castell D, Bagin R, Goldlust B, et al.: Comparison of the effects of immediate-release omeprazole powder for oral suspension and pantoprazole delayed-release tablets on nocturnal acid breakthrough in patients with symptomatic gastro-oesophageal reflux disease. Aliment Pharmacol Ther 2005, 21:1467–1474.

    Article  PubMed  CAS  Google Scholar 

  21. Katz PO, Koch FK, Ballard ED, et al.: Comparison of the effects of immediate-release omeprazole oral suspension, delayed-release lansoprazole capsules and delayed-release esomeprazole capsules on nocturnal gastric acidity after bedtime dosing in patients with night-time GERD symptoms. Aliment Pharmacol Ther 2007, 25:197–205.

    Article  PubMed  CAS  Google Scholar 

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Correspondence to Philip O. Katz.

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Katz, P.O., Dudnick, R.S. Nocturnal acid breakthrough on proton pump inhibitor therapy: To treat or not to treat. Curr Treat Options Gastro 11, 29–34 (2008). https://doi.org/10.1007/s11938-008-0004-z

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  • DOI: https://doi.org/10.1007/s11938-008-0004-z

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