Endoscopic ultrasonographic evaluation of gastric ulcer healing on treatment with proton pump inhibitors versus H2-receptor antagonists.
BACKGROUND
It has been reported that time to peptic ulcer healing is shorter with proton pump inhibitors (PPI) than with H2-receptor antagonists (H2-RA). This study was designed to examine the difference in the healing process between gastric ulcers treated with PPI and those treated with H2-RA.


METHODS
The healing of deep gastric ulcers treated with PPI (n = 11) or H2-RA (n = 13) was evaluated with endoscopic ultrasonography (EUS). Every 2 weeks during treatment EUS variables such as the width and the depth of the ulcer crater, the thickness and size of the low echoic area of the ulcer base, and the distance of the disrupted muscularis propria were measured. The contraction rates of EUS variables, the ratios of the contraction rate of the depth to that of the width of the ulcer crater (D/W ratio) and the contraction rate of the distance of the disrupted muscularis propria layer to that of the width of the ulcer crater (Dm/W ratio) were calculated.


RESULTS
Only at week 2 were the D/W ratio and Dm/W ratio significantly higher in the group receiving PPI (D/W ratio, 1.79 +/- 0.701; Dm/W ratio, 0.938 +/- 0.207) than in the group receiving H2-RA (D/W ratio, 1.10 +/- 0.559; Dm/W ratio, 0.641 +/- 0.166).


CONCLUSIONS
This study demonstrated that PPI therapy is associated with more rapid and stronger healing than obtained with H2-RA during the early treatment period.
Tanaka
M
M
Third Dept. of Internal Medicine, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Maruoka
A
A
Chijiiwa
Y
Y
Tanaka
M
M
Nawata
H
H
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000328:Adult; D000368:Aged; D000897:Anti-Ulcer Agents / Q000627:therapeutic use*; D015738:Famotidine / Q000627:therapeutic use; D005260:Female; D005773:Gastroscopy; D006635:Histamine H2 Antagonists / Q000627:therapeutic use*; D006801:Humans; D064747:Lansoprazole; D008297:Male; D008875:Middle Aged; D016567:Nizatidine / Q000627:therapeutic use; D009853:Omeprazole / Q000031:analogs & derivatives / Q000627:therapeutic use; D010880:Piperidines / Q000627:therapeutic use; D054328:Proton Pump Inhibitors; D013276:Stomach Ulcer / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology; D018084:Ultrasonography, Interventional; D014945:Wound Healing / Q000187:drug effects*
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000897:Anti-Ulcer Agents; D006635:Histamine H2 Antagonists; D010880:Piperidines; D054328:Proton Pump Inhibitors; D064747:Lansoprazole; D015738:Famotidine; D009853:Omeprazole; D016567:Nizatidine; C053742:roxatidine acetate