Dynamics of Serum Pepsinogens on the Background of Double Standard Doses of Omeprazole in Patients with Gastroesophageal Reflux Disease and Functional Gastric Dyspepsia

In literature it has been reported that concentrations of serum pepsinogens increase during administration of proton pump inhibitors (PPI). However, the magnitude of these changes is still to be assessed. The aim of this study was to evaluate the changes in levels of pepsinogen I (PG-1) and pepsinogen II (PG-2) on the background of therapy with omeprazole which has been administered before breakfast in double standard dose (40 mg). The regimen of PPI administration completely corresponds to conventional PPI-test. There were two groups of patients: 1st one (gastroesophageal reflux desiase) — 10 women and 9 men, mean age (52.37 ± 3.25) years; 2nd one (functional dyspepsia) — 11 women and 8 men, mean age (48.37 ± 3.56) years. It was found that in 1st group PGI rises from (141.90 ± 7.99) mcg/l to (177.61 ± 7.81) mcg/l, in 2nd group — from (115.02 ± 10.16) mcg/l to (152.37 ± 12.33) mcg/l (p < 0.05). PG-2 level changes in the same. In 1st group PG-2 rises from (21.65 ± 3.13) mcg/l to (32.64 ± 3.42) mcg/l, in 2nd group — from (14.84 ± 1.64) mcg/l to (23.55 ± 2.37) mcg/l (p < 0.05). In 6 cases absolute increase of PGI (ΔPG-2) didn’t reach threshold of 7.0 mcg/l considered by us as level of insufficient acid inhibition. Two of these patients had atrophic gastritis (PG-1 < 50 mcg/l; ratio PG-/PG-2 < 3.0), rest 4 patients didn’t have atrophic gastritis but in half cases they hadn’t adequate answer to PPI administration. There was a significant correlation between increase of PG-1 level and disappearance of reflux complaints evaluated by dynamics in RS-cluster of GSRS-questionnaire