The Effect of Proton Pump Inhibitor on Healing of Post-esophageal Variceal Ligation Ulcers.
- Author:
Gwi Beom BOO
1
;
Jong Chan OH
;
Beom Ju LEE
;
Dong Min LEE
;
Young Dae KIM
;
Chan Guk PARK
;
Man Woo KIM
Author Information
1. Department of Internal Medicine, Chosun University College of Medicine, Gwangju, Korea. boogbim@yahoo.co.kr
- Publication Type:Original Article ; English Abstract ; Randomized Controlled Trial
- Keywords:
Esophageal variceal ligation;
Ulcer;
Proton pump inhibitor;
Symptom score
- MeSH:
2-Pyridinylmethylsulfinylbenzimidazoles/administration & dosage/*therapeutic use;
Anti-Ulcer Agents/administration & dosage/*therapeutic use;
Esophageal and Gastric Varices/complications/*surgery;
Esophagoscopy;
Female;
Gastrointestinal Hemorrhage/prevention & control;
Humans;
Ligation;
Male;
Middle Aged;
Proton Pump Inhibitors/administration & dosage/*therapeutic use;
Regression Analysis;
Sickness Impact Profile;
Ulcer/*drug therapy/etiology
- From:The Korean Journal of Gastroenterology
2008;51(4):232-240
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUNE/AIMS: Esophageal variceal ligation (EVL) is the most preferable method for controling variceal bleeding. However, EVL is associated with complications such as hemorrhage, chest pain, dysphagia, and odynophagia due to post-EVL ulcers in the esophageal mucosa. The aim of this study was to assess the effect of proton pump inhibitor (PPI), pantoprazole on the healing of post-EVL ulcers. METHODS: Forty seven patients were randomly allocated into PPI group and control group. Patients in PPI group received 40 mg of pantoprazole intravenously for 3 days after EVL, then 40 mg of oral pantoprazole for 11 days consecutively. Control patients received intravenous and oral placebo. Endoscopic examinations were performed twice at 7+/-2 days and 14+/-2 days after EVL respectively. Clinical outcomes include the size of ulcers, symptoms reported by patients; chest pain, dysphagia, and odynophagia. RESULTS: Forty seven patients completed the 7 days protocol (PPI/control; 25/22), and twenty six patients completed the 14 days protocol (PPI/control; 16/10). Post-EVL ulcers in PPI group were significantly smaller than those in control group (7 days; 98.7 mm2/119.4 mm2, 14 days; 32.3 mm2/43.8 mm2, p<0.01). No difference was observed between two the groups with respect to summations of symptom scores (p>0.05). Nineteen patients (PPI/control; 9/10) did not complete the 14 days protocol due to patients' refusal and adverse outcomes, such as hepatic failure and sepsis with bleeding from post-EVL ulcer occurred in two patients of control group. CONCLUSIONS: PPI treatment following EVL may be effective in healing post-EVL ulcer.
