Intragastric acidity and circadian rhythm.

Area of Science:

• Gastroenterology
• Chronobiology
• Microbiology

Background:

• Nocturnal epigastric and retrosternal pain are common in peptic ulcer and gastroesophageal reflux disease, potentially linked to disturbed circadian rhythms of gastric acid secretion.
• Helicobacter pylori is a key factor in duodenal ulcers, but its eradication can worsen gastroesophageal reflux disease.
• The influence of H. pylori infection on the circadian rhythm of gastric acid secretion remains unclear.

Purpose of the Study:

• To investigate whether the circadian rhythm of gastric acid secretion differs between H. pylori-positive and H. pylori-negative individuals.
• To explore the relationship between H. pylori infection and gastric acid secretion patterns.

Main Methods:

• Intragastric acidity was measured using a portable pH meter in two groups: 10 H. pylori-positive and 10 H. pylori-negative subjects.
• Circadian rhythm parameters, including amplitude, MESOR, and acrophase, were analyzed.

Main Results:

• Significant differences in circadian rhythmicity of gastric acid secretion were observed between the two groups (P < 0.001).
• H. pylori-positive subjects showed lower mean amplitude (13.3 vs. 28.1) and MESOR (12.4 vs. 22.7) compared to H. pylori-negative subjects.
• Both groups exhibited increased acidity from midnight to early dawn, but H. pylori-positive individuals had lower overall acidity and reduced amplitude.

Conclusions:

• H. pylori infection significantly alters the circadian rhythm of gastric acid secretion.
• The presence of H. pylori is associated with diminished gastric acid secretion rhythmicity and lower acidity levels.
• H. pylori-positive individuals may present with more advanced disease stages, potentially influenced by altered acid secretion patterns.