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This study investigates whether aspirin induces esophageal mucosal injury and whether a proton\u2010pump inhibitor can prevent such injury in relation to CYP2C19 genotypes. Fifteen healthy Japanese volunteers are dosed for 7 days in a 5\u2010way randomly crossover trial: placebo, aspirin 100 mg, rabeprazole 10 mg, and aspirin 100 mg plus rabeprazole 10 mg either once daily or 4 times per day. All subjects undergo endoscopy and 24\u2010hour intragastric pH monitoring on day 7. With the aspirin regimen, esophageal mucosal disorders occur in 7 patients (46.7%) (5, grade M; 2, grade A). The median 24\u2010hour pH differs significantly among subjects who develop grade M or A gastroesophageal reflux disease and those who do not develop gastroesophageal reflux disease; the median pH in grade A gastroesophageal reflux disease is significantly lower (1.5 [range, 1.1\u20131.9]) than that in patients without gastroesophageal reflux disease (5.6 [range, 0.8\u20138.4], P = .04). Rabeprazole significantly inhibits acid secretion irrespective of CYP2C19 genotypes and decreases the incidence of aspirin\u2010related esophageal injury and symptoms according to increasing pH value. Aspirin induces esophageal mucosal injury in an acid\u2010dependent manner. Concomitant proton\u2010pump inhibitor therapy may prevent advanced effects of low\u2010dose aspirin.<\/jats:p>","DOI":"10.1177\/0091270009344983","type":"journal-article","created":{"date-parts":[[2009,11,26]],"date-time":"2009-11-26T05:08:32Z","timestamp":1259212112000},"page":"320-330","source":"Crossref","is-referenced-by-count":17,"title":["Esophageal Mucosal Injury With Low\u2010Dose Aspirin and Its Prevention by 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