A prospective randomized controlled trial of omeprazole for preventing esophageal stricture in grade 2b and 3a corrosive esophageal injuries

Abstract

Objectives

Esophageal stricture is a significant complication of grade 2b and 3a esophageal injuries and causes much patient suffering. Preventing strictures would be beneficial to patients but there are currently no proven effective drugs. This study aimed to evaluate the effect of omeprazole for preventing esophageal stricture in adults with grade 2b and 3a corrosive esophageal injuries.

Methods

This study was an open single-center prospective randomized controlled trial that took place from April 2018 to January 2020. Patients were randomized to standard treatment or 80 mg/day intravenously × 3 days followed by 40 mg/day orally for 4 weeks. They were endoscoped at baseline and 4 weeks post discharge. Strictures were confirmed radiologically.

Results

20 patients were enrolled: 15 with grade 2b and five with grade 3a injuries. Standard care and omeprazole groups numbered 10 each. At 1 month, seven and two patients developed strictures in the standard and omeprazole groups, respectively, p = 0.024, for a risk reduction of 71.4%.

Conclusions

Omeprazole reduced the risk of short-term developing esophageal strictures following grade 2b and 3a corrosive esophageal injuries. Larger studies are needed to reconfirm this finding.

Thai Clinical Trials Registry (TCTR) number TCTR20190504001

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Acknowledgements

We thank the patients for participating in this research. Special thanks to Dr. Bob Taylor for assistance in editing the English version of this manuscript and Dr. Saritphat Orrapin for scrutinizing methodology and for statistical consultation.

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Correspondence to Prasit Mahawongkajit.

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Disclosures

Prasit Mahawongkajit, Prakitpunthu Tomtitchong, Nuttorn Boochangkool, Chatchai Mingmalairak, Surajit Awsakulsutthi and Chittinad Havanond have no conflicts of interest.

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Mahawongkajit, P., Tomtitchong, P., Boochangkool, N. et al. A prospective randomized controlled trial of omeprazole for preventing esophageal stricture in grade 2b and 3a corrosive esophageal injuries. Surg Endosc (2020). https://doi.org/10.1007/s00464-020-07707-0

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Keywords

  • Corrosive esophageal injury
  • Caustic injury
  • Esophageal stricture
  • Omeprazole