Document Detail


The effect of proton pomp inhibitor (PPI : Rabeprazole) on reflux esophagitis after endoscopic injection sclerotherapy (EIS), a randomized control study (24 hour-pH monitoring).
MedLine Citation:
PMID:  24693675     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
BACKGROUND: Transient esophageal ulceration is a common finding after sclerotherapy of varices. These ulcers sometimes cause pain, ulcer bleeding, and stricture formation. Gastroesophageal reflux (GER) after Endoscopic injection sclerotherapy (EIS) is a known cause of worsening ulcer formation. Therefore, an efficient drug for GER is desirable to improve the quality of life of patients with esophageal varices.
METHODS: We randomized 18 Japanese cirrhotic patients who had risky esophageal varices. The patients were randomly allocated into two groups, and during EIS sessions, one group was administered proton pump inhibitor(PPI) (Rabeprazole 20 mg a person once a day), while the other received histamine H2 receptor antagonist (H2-blocker) (famotidine 20 mg a person, twice a day). Gastroesophageal reflux was monitored by a 24-h pH-monitoring catheter introduced into the distal esophagus. Ulcer formation was evaluated using an endoscopic examination. The subjective and objective symptoms were also compared between the two groups.
RESULTS: All patients in the H2-blocker group showed an increased percentage of time with pH < 4.0 after EIS sessions, but no patients in the PPI group showed an increased such symptoms. The H2-blocker group also experienced a significantly higher number of days of heartburn and dysphasia than did the PPI group (p = 0.017, p = 0.042). The rate of ulcer improvement was found to be faster in Rabeprazole group than in H2 blocker group (p = 0.008).
CONCLUSION: These results suggest that Rabeprazole treatment prevents EIS-associated gastroesophageal reflux and promotes ulcer healing. Rabeprazole also improve the subjective symptoms following EIS.
Authors:
Tomohiko Akahoshi; Hirofumi Kawanaka; Morimasa Tomikawa; Hiroshi Saeki; Hideaki Uchiyama; Tetsuo Ikeda; Ken Shirabe; Makoto Hashizume; Yoshihiko Maehara
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Fukuoka igaku zasshi = Hukuoka acta medica     Volume:  104     ISSN:  0016-254X     ISO Abbreviation:  Fukuoka Igaku Zasshi     Publication Date:  2013 Dec 
Date Detail:
Created Date:  2014-04-03     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9423321     Medline TA:  Fukuoka Igaku Zasshi     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  483-9     Citation Subset:  IM    
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