Omeprazole in short term treatment of reflux oesophagitis

W Jafri, Z Abbas, S Hamid, S Abid, H Shah, H Khan
Omeprazole inhibits the gastric secretion by altering the activity of H + /K+ ATPase 1,2 . The drug itself is inactive but is converted to the active form, a sulfonamide in the acid milieu of canaliculi of actively secreting gastric parietal cells 3 . Though the plasma half life is 60 minutes, the drug binds covalently with H+/K+ATPase and duration of action is thereafter increased to greater than 24 hours 4 . Distal oesophagitis is a complication of gastro-oesophageal reflux. Number and
more » ... n of episodes of reflux are important in the pahogenesis 5-7 . The aim of this study was to assess the efficacy of omeprazole 20 mg once daily in our patients for short term treatment of refiux oesophagitis. PATIENTS, METHODS AND RESULTS This was an open labeled, non-comparative single centre study. Outpatients aged 18-70 with endoscopic findings of reflux oesophagitis (grade I to III) were included in the study. Exclusion criteria were pregnant and lactating mothers, treatment with anti-ulcer or anti-refiux drugs within a week prior to inclusion, patients with concomitant gastric or duodenal ulcer, pyloric stenosis, or any malignant lesion as evident on gastroscopy, oesophageal varices, stricture or Barrett's oesophagus, previous gastro-oesophageal surgery, patients with abnormal renal or hepatic functions and patients requiring regular use of NSAIDs. Before entry, the severity of symptoms and personal habits were assessed. A complete physical examination was performed. Lab investigations including complete blood count (CBC), ESR, urinalysis, blood urea nitrogen (BUN), creatinine, biirubin, alanine aminotransferase (ALT) and alkaline phosphatase were done. Endoscopy was performed within a week prior to the inclusion. Informed consent was taken from all the patients. Patients' symptoms like heart burns and pains were graded from 0 (none) to 3 (severe). Occasional episodes not interfering with the normal activity corresponded to grade 1 (mild), episodes interfering with normal activity as grade 2 (moderate), frequent episodes constantly interfering with normal activity as grade 3 (severe). Oesophagitis was graded as follows: Grade I, erythema, hyperemia or mucosal friability; grade II, superficial erosions; grade III, ulcerations and grade W, complications, e.g., strictures. Patients were seen at two and four weeks to record severity of symptoms and any adverse effects, physical examination and check of left over capsules. Concomitant use of anti-refiux or other anti-ulcer drugs was forbidden during the study period. Endoscopy was repeated by the same endoscopist at 29±3 days and laboratory tests performed. Thirty consecutive patients were entered in the study. The clinical characteristics and results are summarized in Table I and II and Figure 1 and 2.
pmid:1299735 fatcat:ufaysxrzb5gkpggt6wej7pcb74