The effect of omeprazole paste on intragastric pH in clinically ill neonatal foals.

Summary

# Editorial Summary: Omeprazole Efficacy in Sick Neonatal Foals Whilst omeprazole paste has previously demonstrated effectiveness at raising gastric pH in healthy newborn foals, its performance in critically ill neonates—who often require nasogastric feeding tubes and may have compromised gastric function—remained unknown. Javsicas and Sanchez conducted continuous intragastric pH monitoring over 24 hours in eight hospitalised foals aged 1–3 days, measuring pH for 12 hours before and after a single 4 mg/kg dose of omeprazole paste administered orally. The drug produced marked improvements: mean intragastric pH increased from 3.19 to 6.20, median pH rose from 4.6 to 6.86, and critically, the proportion of time the stomach remained acidic (below pH 4) dropped dramatically from 32.25% to just 1.1%. These findings are clinically significant because sick neonates are at elevated risk of gastric ulceration due to stress, systemic illness, and compromised mucosal defences; the study confirms that even a single omeprazole dose can substantially mitigate this risk by sustaining a protective pH environment over the 12-hour post-treatment window, supporting its routine use in hospitalised foals requiring intensive supportive care.

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Key Findings

• •Mean intragastric pH increased significantly from 3.19 to 6.20 after omeprazole treatment (p<0.05)
• •Median intragastric pH increased from 4.6 to 6.86 after omeprazole treatment
• •Time spent at pH <4 decreased from 32.25% to 1.1% after treatment
• •Single dose of omeprazole paste at 4 mg/kg body weight effectively raises gastric pH in sick neonatal foals

Conditions Studied