Abstract
Endoscopic variceal sclerotherapy-related esophageal complications are quite common. The potential efficacy of omeprazole in the prevention and treatment of postsclerotherapy esophageal complications was evaluated in 47 patients with portal hypertension in a randomized, placebo-controlled study. Twenty-one patients in the omeprazole group and 23 patients in the placebo group completed the study. The two treatment groups were similar in regards to the etiology of portal hypertension, Child's class, and clinical characteristics. Esophageal ulcers developed in 16 patients in the omeprazole group (2.43 ulcers/patient) and 18 patients in the placebo group (2.39 ulcers/patient). Most of the ulcers (>90%) healed within 14 days in each group. Esophageal strictures requiring dilatation developed in two and one patient in the omeprazole and placebo groups, respectively. There was no statistically significant difference in regards to the complication rate between the two groups. We conclude that omeprazole is not effective for the prevention or treatment of postsclerotherapy esophageal complications.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Bhargava DK, Dasarathy S, Atmakuri SP, Dwivedi M: Comparative efficacy of emergency endoscopic sclerotherapy for active variceal bleeding due to cirrhosis of the liver, noncirhotic portal fibrosis and extra hepatic portal venous obstruction. J Gastroenterol Hepatol 5:432–437, 1990
Terblanche J, Northover J, Bornman P, Kahn D, Barbezat GO, Sellars SL, Saunders SJ: A prospective evaluation of injection sclerotherapy in the treatment of acute bleeding from esophageal varices. Surgery 85:239–245, 1979
Westaby D, Macdougall BR, Williams R: Improved survival following injection sclerotherapy for esophageal varices: Final analysis of a controlled trial. Hepatology 5:827–830, 1985
Bhargava DK, Singh B, Dogra R, Dasarathy S, Sharma MP: Prospective randomised comparison of sodium tetradecyl sulfate and polidocanol as variceal sclerosing agents. Am J Gastroenterol 87:182–186, 1992
Trusdale RA, Wong RKH: Complications of esophageal variceal sclerotherapy. Gastroenterol Clin North Am 20:859–870, 1991
Schuman BM, Beckman JW, Tedesco FJ, Griffin JW Jr, Assad RT: Complications of endoscopic sclerotherapy—a review. Am J Gastroenterol 82:823–830, 1987
Grande L, Planas R, Lacima G, Boix J, Ros E, Esteve M, Morillas R, Gasull MA: Sequential esophageal motility studies after endoscopic injection sclerotherapy: A prospective investigation. Am J Gastroenterol 86:36–40, 1991
Sidhu S, Bal CS, Bhargava DK: Esophageal sclerotherapy induced early and late esophageal dysmotility and gastroesophageal reflux. Indian J Gastroenterol 11:A3, 1992 (abstract)
Polson RJ, Westaby D, Gimson A, Hayes PC, Stellan AJ, Hayllar K, Williams R: Sucralfate for the prevention of early rebleeding following injection sclerotherapy for esophageal varices. Hepatology 10:279–282, 1989
Roark G: Treatment of postsclerotherapy esophageal ulcers with sucralfate. Gastrointest Endosc 39:9–10, 1984
Tamura S, Shiozaki H, Kabayashi K, Yono H, Tahara H, Miyata M, Mori T: Prospective randomised study on the effect of ranitidine against injection ulcer after endoscopic injection sclerotherapy for esophageal varices. Am J Gastroenterol 86:477–480, 1991
Gimson A, Polson R, Westaby D, Williams R: Omeprazole in the treatment of intractble esophageal ulcerations following injection sclerotherapy. Gastroenterology 99:1829–1833, 1990
Johlin FC, Labrecque DR, Neil GA: Omeprazole heals mucosal ulcers associated with endoscopic injection sclerotherapy. Dig Dis Sci 37:1373–1376, 1992
Conn HO: Ammonia tolerance in the diagnosis of esophageal varices: A comparison of endoscopic, radiologic and biochemical techniques. J Lab Clin Med 70:442–451, 1967
Sarles HE Jr, Sanowski RA, Talbert G: Course and complications of endoscopic variceal sclerotherapy: A prospective study of 50 patients. Am J Gastroenterol 80:595–599, 1985
Evans DM, Jones DB, Cleary BK, Smith PM: Oesophageal varices treated by sclerotherapy: A histopathological study. Gut 23:615–620, 1982
Atmakuri SP, Bhargava DK, Sharma MP: Endoscopic sclerotherapy for esophageal varieces: A prospective randomised trial of absolute alcohol versus polidocanol. Indian J Gastroenterol 7:87–89, 1988
Akriviadis E, Korula J, Gupta S, Ko Y, Yamada S: Frequent endoscopic sclerotherapy increases risk of complications. Prospective randomised controlled study of two treatment schedule. Dig Dis Sci 34:1068–1074, 1989
Kitano S, Koyanagi N, Iso Y, Higashi H, Sugimachi K: Prevention of recurrence of esophageal varices after endoscopic sclerotherapy with ethanolamine olecate. Hepatology 7:810–815, 1987
Snady H, Korsten MA: Esophageal acid clearance and motility after endoscopic sclerotherapy of esophageal varices. Am J Gastroenterol 81:419–422, 1986
Sauerbruch T, Wirsching R, Holl J, Grobe J, Weinzierl M: Effects of repeated injection sclerotherapy on acid gastroesophageal reflux. Gastrointest Endosc 32:81–83, 1986
Tabibian N, Smith JL, Graham DY: Sclerotherapy associated esophageal ulcers: lessons from a double blind randomised comparison of sucralfate suspension versus placebo. Gastrointest Endosc 35:312–315, 1989
Vantrappan G, Rutgeerts L, Schurmans P, Coenegrachts JL: Omeprazole (40 mg) is superior to ranitidine in short term treatment of ulcerative reflux esophagitis. Dig Dis Sci 33:523–529, 1988
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Garg, P.K., Sidhu, S.S. & Bhargava, D.K. Role of omeprazole in prevention and treatment of postendoscopic variceal sclerotherapy esophageal complications. Digest Dis Sci 40, 1569–1574 (1995). https://doi.org/10.1007/BF02285210
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02285210