EFFECT OF NIZATIDINE 300 MG AT NIGHT AND OMEPRAZOLE 20 MG IN THE MORNING ON 24-HOUR INTRAGASTRIC PH AND BACTERIAL OVERGROWTH IN PATIENTS WITH ACUTE DUODENAL-ULCER

The study investigated the effect of either nocturnal acid suppression by the H-2 antagonist nizatidine 300 mg at night or prolonged acid su ppression by the proton-pump inhibitor omeprazole 20 mg in the morning , during four weeks, on intragastric pH profile, occurrence of bacteri al growth in gastric fluid and biopsies, and healing rate in 23 patien ts with an acute duodenal ulcer. The endoscopic healing rate did not d iffer significantly between the two treatment modalities. The 24-hr ac id secretion was significantly more reduced by omeprazole than nizatid ine (P < 0.002). After treatment by nizatidine and omeprazole, respect ively, median 24-hr intragastric pH increased from 1.5 to 1.8 (P < 0.0 1) and from 1.5 to 6.1 (P < 0.01), respectively. Nighttime acid inhibi tion did not differ significantly. The difference in gastric bacterial colonization after either omeprazole or nizatidine did not reach sign ificance. However, median 24-hr pH and the fraction of the day with pH < 3 and pH < 4 were significantly correlated to bacterial colonizatio n of the gastric fluid (P < 0.05).