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Endoscopic regression of Barrett's oesophagus during omeprazole treatment; a randomised double blind study.
Gut. 1999 Oct; 45(4):489-94.Gut

Abstract

BACKGROUND

Barrett's oesophagus, columnar metaplasia of the epithelium, is a premalignant condition with a 50-100-fold increased risk of cancer. The condition is caused by chronic gastro-oesophageal reflux. Regression of metaplasia may decrease the cancer risk.

AIMS

To determine whether elimination of acid gastro-oesophageal reflux induces a regression of metaplastic epithelium.

METHODS

Sixty eight patients with acid reflux and proven Barrett's oesophagus were included in a prospective, randomised, double blind study with parallel groups, and were treated with profound acid secretion suppression with omeprazole 40 mg twice daily, or with mild acid secretion suppression with ranitidine 150 mg twice daily, for 24 months. Endoscopy was performed at 0, 3, 9, 15, and 24 months with measurement of length and surface area of Barrett's oesophagus; pH-metry was performed at 0 and 3 months. Per protocol analysis was performed on 26 patients treated with omeprazole, and 27 patients treated with ranitidine.

RESULTS

Omeprazole reduced reflux to 0.1%, ranitidine to 9.4% per 24 hours. Symptoms were ameliorated in both groups. There was a small, but statistically significant regression of Barrett's oesophagus in the omeprazole group, both in length and in area. No change was observed in the ranitidine group. The difference between the regression in the omeprazole and ranitidine group was statistically significant for the area of Barrett's oesophagus (p=0. 02), and showed a trend in the same direction for the length of Barrett's oesophagus (p=0.06).

CONCLUSIONS

Profound suppression of acid secretion, leading to elimination of acid reflux, induces partial regression of Barrett's oesophagus.

Authors+Show Affiliations

Department of Gastroenterology and Hepatology, University Hospital Groningen, Groningen, The Netherlands.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

10486353

Citation

Peters, F T., et al. "Endoscopic Regression of Barrett's Oesophagus During Omeprazole Treatment; a Randomised Double Blind Study." Gut, vol. 45, no. 4, 1999, pp. 489-94.
Peters FT, Ganesh S, Kuipers EJ, et al. Endoscopic regression of Barrett's oesophagus during omeprazole treatment; a randomised double blind study. Gut. 1999;45(4):489-94.
Peters, F. T., Ganesh, S., Kuipers, E. J., Sluiter, W. J., Klinkenberg-Knol, E. C., Lamers, C. B., & Kleibeuker, J. H. (1999). Endoscopic regression of Barrett's oesophagus during omeprazole treatment; a randomised double blind study. Gut, 45(4), 489-94.
Peters FT, et al. Endoscopic Regression of Barrett's Oesophagus During Omeprazole Treatment; a Randomised Double Blind Study. Gut. 1999;45(4):489-94. PubMed PMID: 10486353.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Endoscopic regression of Barrett's oesophagus during omeprazole treatment; a randomised double blind study. AU - Peters,F T, AU - Ganesh,S, AU - Kuipers,E J, AU - Sluiter,W J, AU - Klinkenberg-Knol,E C, AU - Lamers,C B, AU - Kleibeuker,J H, PY - 1999/9/16/pubmed PY - 1999/9/16/medline PY - 1999/9/16/entrez SP - 489 EP - 94 JF - Gut JO - Gut VL - 45 IS - 4 N2 - BACKGROUND: Barrett's oesophagus, columnar metaplasia of the epithelium, is a premalignant condition with a 50-100-fold increased risk of cancer. The condition is caused by chronic gastro-oesophageal reflux. Regression of metaplasia may decrease the cancer risk. AIMS: To determine whether elimination of acid gastro-oesophageal reflux induces a regression of metaplastic epithelium. METHODS: Sixty eight patients with acid reflux and proven Barrett's oesophagus were included in a prospective, randomised, double blind study with parallel groups, and were treated with profound acid secretion suppression with omeprazole 40 mg twice daily, or with mild acid secretion suppression with ranitidine 150 mg twice daily, for 24 months. Endoscopy was performed at 0, 3, 9, 15, and 24 months with measurement of length and surface area of Barrett's oesophagus; pH-metry was performed at 0 and 3 months. Per protocol analysis was performed on 26 patients treated with omeprazole, and 27 patients treated with ranitidine. RESULTS: Omeprazole reduced reflux to 0.1%, ranitidine to 9.4% per 24 hours. Symptoms were ameliorated in both groups. There was a small, but statistically significant regression of Barrett's oesophagus in the omeprazole group, both in length and in area. No change was observed in the ranitidine group. The difference between the regression in the omeprazole and ranitidine group was statistically significant for the area of Barrett's oesophagus (p=0. 02), and showed a trend in the same direction for the length of Barrett's oesophagus (p=0.06). CONCLUSIONS: Profound suppression of acid secretion, leading to elimination of acid reflux, induces partial regression of Barrett's oesophagus. SN - 0017-5749 UR - https://www.unboundmedicine.com/medline/citation/10486353/Endoscopic_regression_of_Barrett's_oesophagus_during_omeprazole_treatment L2 - http://gut.bmj.com/cgi/pmidlookup?view=long&pmid=10486353 DB - PRIME DP - Unbound Medicine ER -