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|Title:||Long-term omeprazole treatment in resistant gastroesophageal reflux disease: Efficacy, safety, and influence on gastric mucosa|
|Citation:||Gastroenterology, 2000; 118(4):661-669|
|Publisher:||W B Saunders Co|
|Abstract:||BACKGROUND & AIMS:The efficacy and safety of long-term acid suppression remains a subject for debate. We report data from patients with refractory reflux esophagitis who were undergoing maintenance therapy with >/=20 mg omeprazole daily for a mean period of 6.5 years (range, 1.4-11.2 years). METHODS:Patients with severe reflux esophagitis resistant to long-term therapy with H(2)-receptor antagonists and who were not eligible for surgery were evaluated at least annually for endoscopic relapse and histological changes in the gastric corpus. RESULTS:In 230 patients (mean age, 63 years at entry; 36% were >/=70 years), there were 158 relapses of esophagitis during 1490 treatment years (1 per 9.4 years), with no significant difference in relapse rates between Helicobacter pylori-positive and -negative patients. All patients rehealed during continued therapy with omeprazole at the same or higher dose. The annual incidence of gastric corpus mucosal atrophy was 4.7% and 0.7% in H. pylori-positive and -negative patients, respectively, which was mainly observed in elderly patients who had moderate/severe gastritis at entry. In patients with baseline moderate/severe gastritis, the incidences were similar: 7.9% and 8.4%, respectively. Corpus intestinal metaplasia was rare, and no dysplasia or neoplasms were observed. The adverse event profile was as might be expected from this elderly group of patients. CONCLUSIONS:Long-term omeprazole therapy (up to 11 years) is highly effective and safe for control of reflux esophagitis.|
|Keywords:||Long-Term Study Group; Gastric Mucosa; Humans; Helicobacter Infections; Barrett Esophagus; Gastroesophageal Reflux; Esophagitis; Gastritis; Hyperplasia; Omeprazole; Gastrins; Anti-Ulcer Agents; Treatment Outcome; Drug Resistance; Time Factors; Adolescent; Adult; Aged; Aged, 80 and over; Middle Aged; Child; Female; Male|
|Appears in Collections:||Medicine publications|
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