Criteria of effective acid inhibition during antihelicobacter pharmacotherapy (according to the findings of express-gastro-pH-monitoring)

Abstract

Objective — to establish the criteria of pH values of express-gastro-pH-monitoring for successful eradication of Helicobacter pylori).Materials and methods. The analysis has been performed for the results of express-gastro-pH-monitoring in 49 patients with H. pylori-infected,acid-depended diseases of esophagus, stomach and duodenum. The patients were administered three-component anti-helicobacter pharmacotherapy in standard doses twice a day: proton pump inhibitor + clarithromycin + amoxicillin or ornidazole. The course of treatment was 7 days. Express-gastro-pH-monitoring was carried out on 6.7 ± 0.6 day of administration of three-component scheme of H. pylori eradication using Acidogastrograph AG-1рН and gastrointestinal electrode system, created by medical engineering team under the guidance of V. M. Professor Chernobroviy. The results of control 13C-urea breath test (IRIS, Wagner, Germany) the patients were divided into two groups: group 1 consisted of 39 patients (23 men and 16 women) with successful H. pylori eradication, and group two, involving 10 patients (5 men and 5 women) with failed anti-helicobacter treatment. The mean age of group 1 was 41.7 ± 2.7 years, height 171.2 ± 1.5 cm, body mass 70.5 ± 2.2 kg. The mean age in the group 2 was 46.4 ± 5.8 years, height 169.6 ± 2.1 cm, body mass 68.8 ± 2.6 kg.Results. During the express-gastro-pH-monitoring, in the group with unsuccessful H. pylori eradication (group 2) the mean values of intragastric pH > 5.0 units were observed only in 5 (12.5 %) measurement points (40, 41 cm during pH-microprobe insertion and 60, 59 and 58 cm during pH-microprobe removal), whereas in patients with successful H. pylori eradication (group 1) the mean values of intragastric pH > 5,0 were observed in all measurement points during insertion of pH-microprobe as well as during its excretion from the stomach. In patients with failed H. pylori eradication (group 2), the significantly lower (p < 0.05) indices of intragastric pH were observed comparing with patients with successful H. pylori eradication (group 1). In particular, min pH was (3.6 ± 0.45 vs 4.8 ± 0.33), max pH (of 5.6 ± 0.56 vs 6.8 ± 0.16), X pH (4.2 ± 0.61 vs 5.6 ± 0.28), Mo pH (3.9 ± 0.76 vs 5.7 ± 0.3) and Me pH (4.0 ± 0.55 vs 5.5 ± 0.3). The close correlation (р < 0.03) has been established between the successful H. pylori eradication and intragastric max pH index (r = 0.3) during anti-helicobacter pharmacotherapy, and (р < 0.05) between successful H. pylori eradication and mean intragastric pH X index (r = 0.27). Moreover, the correlation has been reveled (р < 0.03) between successful H. pylori eradication and increased intragastric pH Mo (r = 0.3).Conclusions. Express-gastro-pH monitoring can be used as a screening method for monitoring of antisecretory action of the efficacy of hydrochloric acid secretion blockers and forecasting of the successfulness of H. pylori eradication. The parameters of intragastric pH (based on the results of express-gastro-pH monitoring) in the course ofantihelicobacter pharmacotherapy) should be: max pH 6.8, X pH 5,6 and Mo pH 5.7, due to the close correlation established for these parameters and successful H. pylori eradication.