| Pantoprazole reduces the size of postbanding ulcers after variceal band ligation: a randomized, controlled trial. | |
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MedLine Citation:
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PMID: 15726658 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Elective esophageal variceal ligation (EVL) is performed to decrease the risk of variceal hemorrhage. Side effects of EVL include hemorrhage, chest pain, dysphagia, and odynophagia. Because gastric acid may exacerbate postbanding ulcers and delay healing, proton pump inhibition may decrease side effects associated with EVL. The aim of this study was to assess the efficacy of pantoprazole, a proton pump inhibitor, as an adjunct to elective EVL. We performed a double-blinded, randomized, placebo-controlled trial of pantoprazole after elective EVL. Subjects in the pantoprazole arm received 40 mg pantoprazole intravenously after EVL followed by 40 mg oral pantoprazole for 9 days. Control subjects received intravenous and oral placebo. Subjects underwent upper endoscopy 10 to 14 days after banding. Primary outcomes included the size and number of ulcers and the subjects' reports of dysphagia, chest pain, and heartburn. Forty-four subjects were randomized: 42 completed the protocol. At follow-up endoscopy, the mean number of ulcers was similar in the two groups. However, the ulcers in the pantoprazole group were on average half as large as in the placebo group (37 mm(2) vs. 82 mm(2), P < .01). Chest pain, dysphagia, and heartburn scores were not significantly different. Four subjects, all in the placebo group, had adverse outcomes, including 3 who bled from postbanding ulcers and 1 with sepsis. In conclusion, subjects receiving pantoprazole after elective EVL had significantly smaller postbanding ulcers on follow-up endoscopy than subjects receiving placebo. However, the total ulcer number and patient symptoms were not different between the groups. |
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Authors:
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Nicholas J Shaheen; Eugene Stuart; Sarah M Schmitz; Kate L Mitchell; Michael W Fried; Steven Zacks; Mark W Russo; Joseph Galanko; Roshan Shrestha |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S. |
Journal Detail:
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Title: Hepatology (Baltimore, Md.) Volume: 41 ISSN: 0270-9139 ISO Abbreviation: Hepatology Publication Date: 2005 Mar |
Date Detail:
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Created Date: 2005-02-28 Completed Date: 2005-03-17 Revised Date: 2007-11-14 |
Medline Journal Info:
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Nlm Unique ID: 8302946 Medline TA: Hepatology Country: United States |
Other Details:
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Languages: eng Pagination: 588-94 Citation Subset: IM |
Affiliation:
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Division of Gastroenterology and Hepatology, University of North Carolina School of Medicine, Chapel Hill, NC, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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2-Pyridinylmethylsulfinylbenzimidazoles Benzimidazoles / therapeutic use* Double-Blind Method Esophageal and Gastric Varices / complications, surgery* Female Gastrointestinal Hemorrhage / prevention & control Humans Ligation / adverse effects Male Middle Aged Omeprazole / analogs & derivatives*, therapeutic use* Sulfoxides / therapeutic use* Ulcer / prevention & control* |
| Grant Support | |
ID/Acronym/Agency:
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K23DK59311-01/DK/NIDDK NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/2-Pyridinylmethylsulfinylbenzimidazoles; 0/Benzimidazoles; 0/Sulfoxides; 102625-70-7/pantoprazole; 73590-58-6/Omeprazole |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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