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From: Melissa Tessie@netcom.com
Date: 5/7/00
Time: 7:08:33 PM
Remote Name: 199.183.9.109
There are probably various reasons why people stil have heartburn while on PPIs. Some medications work better in some people than others. Maybe the drugs stop over 90% of the acid in most people, but most people isn't the same as "all people." According to what I've read (including an article by Dr. DeMeester on the USC site) a significant number of people (I forget the percentage) reflux both bile and stomach acid. The bile reflux does cause damage. I don't know this for certain, but I wouldn't be surprised if bile reflux also causes heartburn. PPIs don't do anything to reduce bile production, as far as I know, so maybe that would also explain people still feeling heartburn?