Editorial
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World J Gastrointest Pharmacol Ther. Oct 6, 2010; 1(5): 102-106
Published online Oct 6, 2010. doi: 10.4292/wjgpt.v1.i5.102
Which is the best choice for gastroesophageal disorders: Melatonin or proton pump inhibitors?
Joanna Dulce Favacho de Oliveira Torres, Ricardo de Souza Pereira
Joanna Dulce Favacho de Oliveira Torres, Universidade Federal do Amapá, Campus Universitário Marco Zero do Equador, Rod. Juscelino Kubitschek, KM-02, Jardim Marco Zero, CEP 68.902-280, Macapá, AP, Brazil
Ricardo de Souza Pereira, Laboratório de Laser e Microscopia de Força Atômica, Dr. Nivaldo Parizotto, Departamento de Fisioterapia, Universidade Federal de São Carlos, Rod. Washington Luís, São Carlos, SP, Brazil
Author contributions: Oliveira-Torres JDF is credited with valuable discussions related to patient biopsy samples, drawing of the structures, acquisition, analysis and interpretation of data (database search work in pubmed and web of science), organization of references and valuable discussions about the questions of referees; Pereira RS is credited with the main idea of chemical structure comparison between omeprazole and melatonin and the possible mechanism of action, writing of the manuscript and answers for the referees.
Supported by CNPq (Conselho Nacional de Desenvolvimento Científico e Tecnológico) (Proc. No. 303358/2009-2)
Correspondence to: Dr. Ricardo de Souza Pereira, Professor, Laboratório de Laser e Microscopia de Força Atômica, Dr. Nivaldo Parizotto, Departamento de Fisioterapia, Universidade Federal de São Carlos, Rod. Washington Luís, São Carlos, SP, Brazil. ricardodesouzapereira@yahoo.com.br
Telephone: +55-19-81841411 Fax: +55-19-21177209
Received: April 7, 2010
Revised: September 16, 2010
Accepted: September 23, 2010
Published online: October 6, 2010
Abstract

Melatonin is used in many countries to improve sleep disorders. Melatonin is a hormone produced by the pineal gland and enterochromaffin cells which control sleep and gastrointestinal motility. Low levels of melatonin lead to gastroesophageal reflux disease (GERD). Most of patients with GERD have a sleep disorder. So, low melatonin levels is the main cause of insomnia. Beyond this, it has an inhibitory action on gastric acid secretion and seems to control the lower esophageal sphincter. Proton pump inhibitors (PPIs) are a group of drugs whose main action is a pronounced and long-lasting reduction of gastric acid production. They are the most potent inhibitors of acid secretion available today. Omeprazole (one of the PPIs) and melatonin have similarities in their chemical structures. Therefore, we could consider omeprazole as a rough copy of melatonin. In this paper, we compare the advantages and disadvantages of the clinical use of melatonin and PPIs.

Keywords: Melatonin, Sleep disorder, Gastroesophageal reflux disease, Omeprazole, Ulcers, Gastritis