Can Omeprazole allow healing of certain ulcerated esophagitis?
The potential of omeprazole for the therapy of peptic esophagitis has been investigated in three separate studies conducted within Australia. The minimum criterion for enrolment of patients in these studies was erosive peptic esophagitis. This was graded in severity according to the extent and appearances of ulceration in the distal 5 cm of the esophageal mucosa as follows: grade 2, less than 10% ulceration: grade 3, from 10 to 50% ulceration, and grade 4 more than 50% ulceration, or a deep chronic appearing ulcer, regardless of the area of ulceration. The first study performed was an open therapy pilot study on eight patients who were treated with omeprazole 30 mg daily for 8 weeks. Prior to this, simultaneous 3 hour post prandial recordings of esophageal motility and esophageal and gastric pH were made. These measurements were repeated during the 7th week of therapy with omeprazole. Macroscopic ulceration had healed in 7 of 8 patients after 8 weeks therapy. The esophageal pH recordings made during therapy showed abolition of all episodes of exposure of the esophagus to a pH of less than 4. This effect was dependent upon the very effective antisecretory action of omeprazole, since gastric pH was also maintained above 4. The motihty recordings showed no detectable effect of omeprazole on patterns of lower esophageal sphincter and esophageal body motor function. In particular, the frequency of gastro-esophageal reflux episodes, as determined by manometric indices of reflux, was unchanged by omeprazole therapy.
KeywordsPlacebo Acidity Omeprazole Ranitidine Esophagitis
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