Regression of columnar-lined (Barrett's) oesophagus with omeprazole 40 mg daily: results of 5 years of continuous therapy.
BACKGROUND
We have previously reported the effect of 2 years of omeprazole 40 mg daily on columnar-lined (Barrett's) oesophagus (CLO).


OBJECTIVE
In the present study, follow-up has been extended to 5 years to assess the macroscopic and microscopic effects of continuing therapy.


METHODS
The 23 patients have been followed for up to a further 3 years. Endoscopy with multiple biopsies was performed at the end of years 3, 4 and 5.


RESULTS
Although there had been a statistically significant regression in the length of CLO after 2 years, there was no overall further measurable change after 5 years. However, one patient showed complete macroscopic and microscopic regression. The number and size of macroscopic squamous islands within the CLO continued to increase, and there was a further increase in microscopic squamous re-epithelialization of surface mucosa, gland ducts and Barrett's gland tissue. Low-grade dysplasia was found consistently in one patient in biopsies taken up to the end of year 3 but it could not be detected thereafter.


CONCLUSIONS
Omeprazole 40 mg daily appears to have beneficial effects on CLO, although it rarely induces a complete regression. Whether the benefits will reduce the risk of malignant transformation is unknown.
Wilkinson
S P
SP
Gloucestershire Royal Hospital, Great Western Road, Gloucester, UK.
Biddlestone
L
L
Gore
S
S
Shepherd
N A
NA
D000368:Aged; D000897:Anti-Ulcer Agents / Q000008:administration & dosage*; D001471:Barrett Esophagus / Q000188:drug therapy* / Q000473:pathology; D004334:Drug Administration Schedule; D016099:Endoscopy, Gastrointestinal; D004791:Enzyme Inhibitors / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009853:Omeprazole / Q000008:administration & dosage*; D016896:Treatment Outcome
D000897:Anti-Ulcer Agents; D004791:Enzyme Inhibitors; D009853:Omeprazole