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KMID : 0614620080510040232
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Korean Journal of Gastroenterology
2008 Volume.51 No. 4 p.232 ~ p.240
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The Effect of Proton Pump Inhibitor on Healing of Post-esophageal Variceal Ligation Ulcers
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Boo Gwi-Beom
Oh Jong-Chan
Lee Beom-Ju
Lee Dong-Min
Kim Young-Dae
Park Chan-Guk
Kim Man-Woo
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Abstract
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Background/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.
Conclusion: PPI treatment following EVL may be effective in healing post-EVL ulcer.
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KEYWORD
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Esophageal variceal Ligation, Ulcer, Proton pump inhibitor, Symptom score
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