NOCTURNAL ACID BREAKTHROUGH IN PEPTIC ULCER DISEASE
A study of the frequency and clinical significance of nocturnal acid breakthrough (NAB) in 178 patients with ulcer disease receiving standard doses of proton pump inhibitors. All patients underwent daily intragastric pH-metry on the 7th day of treatment. In 20 % of patients with peptic ulcer with nominally effective antisecretory therapy (pH>3.0 more than 75 % of the day) revealed NAB. They were accompanied with pathological acid gastroesophageal reflux, decreased the duration of time intragastric pH more than 5.0. NAB should therefore be regarded as a variant of insufficient antisecretory therapy. The NAB detection rate did not depend on sex, localization of the ulcer, the presence of Helicobacter pylori. Predictors of NAB served young age, presence of esophagitis, erosive gastritis/gastroduodenitis. In the treatment of ulcers associated with NAB were found more often in torpid pain and dyspeptic syndrome, increase the average maturity of scarring ulcers, slow recovery of the mucosa of the esophagus.