Factors Responsible for Nocturnal Intragastric pH Elevation in Helicobacter pylori-Positive Gastric Ulcer Patients
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概要
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A remarkable increase in intragastric pH during nighttime (nocturnal intragastric pH elevation : NIPE) is often observed in Helicobacter pylori (H. pylori)-positive gastric ulcer patients. We investigated factors of NIPE. Ambulatory 24h intragastric pH monitoring and sampling gastric juice in the fundus through a naso-gasric tube and blood from the forearm vein at 22 : 00, 0 : 00, 2 : 00, 4 : 00, 6 : 00, and 7 : 00 were performed simultaneously in 20 patients with H. pylori-positive gastric ulcer at healing stage. The patients were divided into the following three groups in accordance with the time ratio of intragastric pH more than 3 from 22 : 00 to 7 : 00; group A : over 50%, 6 cases; group B : 1-50%, 10 cases; and group C : 0%, 4 cases. Histological inflammation score on corpus, bile acid and ammonia levels in gastric juice showed a significant decrement trend from group A toward group C. Serum gastrin levels tended to be higher in group A. A positive correlation was observed between pH of collected gastric juice and bile acid level. Any correlations were not obtained among pH, ammonia, and serum gastrin levels. Evaluating time courses of pH of collected gastric juice in group A and B, the sample collected at 4 : 00 showed the highest pH and the lowest acidity value. In patients with low gastric acid output with H. pylori-induced severe corpus gastritis, a decrease in acid secretion by nature in accordance with the circadian rhythm and bile reflux might be among crucial etiologies which explain the NIPE phenomenon.
- 愛知医科大学の論文
- 2006-03-15
著者
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KAKUMU Shinichi
Department of Internal Medicine, GI Division, Aichi Medical University School of Medicine
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HAYAKAWA Toshihiko
Department of Applied Plant Science, Graduate School of Agricultural Science, Tohoku University
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Kakumu Shinichi
Department Of Internal Medicine Division Of Gastroenterology Aichi Medical University School Of Medi
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FUNAKI YASUSHI
Department of Laboratory Medicine, Aichi Medical University School of Medicine
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KANEKO HIROSHI
Pathophysiology and Therapeutics, Aichi Medical University College of Nursing
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KONAGAYA TOSHIHIRO
Department of Internal Medicine, Division of Gastroenterology, Aichi Medical University School of Me
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HIROOKA YOSHIFUMI
Department of Laboratory Medicine, Aichi Medical University School of Medicine
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Hayakawa Toshihiko
Department Of Internal Medicine Division Of Gastroenterology Aichi Medical University School Of Medi
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Funaki Yasushi
Department Of Laboratory Medicine Aichi Medical University School Of Medicine:department Of Internal
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Kakumu Shinichi
Department Of Gastroenterology Aichi Medical University School Of Medicine
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Hirooka Yoshifumi
Department Of Laboratory Medicine Aichi Medical University School Of Medicine
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Hayakawa Toshihiko
Department Of Applied Plant Science Grasuate School Of Agricultural Science Tohoku University
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Funaki Yasushi
Department Of Gastroenterology Aichi Medical University School Of Medicine
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Konagaya Toshihiro
Department Of Internal Medicine Division Of Gastroenterology Aichi Medical University School Of Medi
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Kaneko Hiroshi
Pathophysiology And Therapeutics Aichi Medical University College Of Nursing
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Kaneko Hiroshi
Pathology Nagaoka Red Cross Hospital
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HIROOKA Yoshifumi
Department of Laboratory Medicine
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