Document Detail


A comparison of omeprazole and ranitidine in the prevention of recurrence of benign esophageal stricture. Restore Investigator Group.
MedLine Citation:
PMID:  7926495     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND/AIMS: Dilatation combined with subsequent pharmacological control of gastroesophageal reflux represents a logical but poorly documented approach to the management of benign esophageal stricture. This large trial (366 patients) aimed to assess whether omeprazole as the most effective available medication for gastroesophageal reflux disease prevents recurrent stricture formation. METHODS: Patients (n = 366) were randomized in a double-blind study to undergo either omeprazole (20 mg once daily; 180 evaluable patients) or ranitidine therapy (150 mg twice daily; 185 evaluable patients) for 1 year after dilatation to 12-18-mm diameter (36-54F gauge). Subsequently, endoscopy and dilatation were performed when clinically indicated and endoscopy on completion. Symptoms were assessed at clinic visits every 3 months and using weekly diary cards. RESULTS: Fewer patients undergoing omeprazole therapy required redilatation compared with those on ranitidine (43 of 143 [30%] vs. 66 of 143 [46%] by 12 months; P < 0.01), and patients in the omeprazole group needed fewer redilatations during the year (0.48 vs. 1.08; P < 0.01). On completion, symptom relief favored omeprazole: 76% of patients in the omeprazole group were free of dysphagia (compared with 64% in the ranitidine group; P < 0.05); 83% were able to accept a normal diet (69%; P < 0.01); and 65% were completely asymptomatic (43%; P < 0.001). CONCLUSIONS: Omeprazole, 20 mg once daily, was more effective than ranitidine, 150 mg twice daily, as prophylaxis against stricture recurrence and in providing symptom relief.
Authors:
P M Smith; G D Kerr; R Cockel; B A Ross; C M Bate; P Brown; M W Dronfield; J R Green; W S Hislop; A Theodossi
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial    
Journal Detail:
Title:  Gastroenterology     Volume:  107     ISSN:  0016-5085     ISO Abbreviation:  Gastroenterology     Publication Date:  1994 Nov 
Date Detail:
Created Date:  1994-11-22     Completed Date:  1994-11-22     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0374630     Medline TA:  Gastroenterology     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1312-8     Citation Subset:  AIM; IM    
Affiliation:
Llandough Hospital, Penarth, South Glamorgan, Wales.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Chi-Square Distribution
Dilatation
Double-Blind Method
Esophageal Stenosis / drug therapy,  prevention & control*,  therapy
Esophagoscopy
Female
Great Britain
Humans
Logistic Models
Male
Middle Aged
Omeprazole / administration & dosage,  therapeutic use*
Ranitidine / administration & dosage,  therapeutic use*
Recurrence
Chemical
Reg. No./Substance:
66357-35-5/Ranitidine; 73590-58-6/Omeprazole
Comments/Corrections
Comment In:
Gastroenterology. 1994 Nov;107(5):1545-8   [PMID:  7926519 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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