Post-cholecystectomy alkaline reactive gastritis: a randomized trial comparing sucralfate versus rabeprazole or no treatment.
OBJECTIVE
At present there are no well-established pharmacological approaches in the management of post-cholecystectomy alkaline reactive gastritis. The aim of this study was to assess the effect of sucralfate versus rabeprazole or no treatment on dyspeptic symptoms and endoscopic/histological signs in a population of patients with a history of cholecystectomy and evidence of alkaline reactive gastritis.


METHODS
Sixty dyspeptic patients fulfilling the following criteria of inclusion took part in this study: (1) a history of cholecystectomy; (2) no use of anti-inflammatory steroidal and non-steroidal drugs, or abuse of alcohol; (3) evidence of abundant gastric bile reflux at endoscopy; (4) endoscopic signs of chronic gastritis; (5) histological signs of chronic gastritis; and (6) absence of Helicobacter pylori infection. Dyspeptic symptoms were evaluated by means of a self-administered validated questionnaire. Patients included in the study were randomly assigned to one of three treatment groups for 3 months: sucralfate, rabeprazole, observation. Patients were re-evaluated at the end of the treatment.


RESULTS
Sucralfate and rabeprazole therapies were both able to significantly reduce epigastric pain, heartburn, bloating and halitosis. Endoscopic/histological signs were lower in both treatment groups compared to the observation group.


CONCLUSIONS
Both sucralfate and rabeprazole therapies are effective treatment options in the patients with alkaline gastritis when compared with observation.
Santarelli
Luca
L
Departmentof Internal Medicine, Catholic University of the Sacred Heart, Rome, Italy.
Gabrielli
Maurizio
M
Candelli
Marcello
M
Cremonini
Filippo
F
Nista
Enrico C
EC
Cammarota
Giovanni
G
Gasbarrini
Giovanni
G
Gasbarrini
Antonio
A
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D000897:Anti-Ulcer Agents / Q000627:therapeutic use*; D001562:Benzimidazoles / Q000627:therapeutic use*; D002763:Cholecystectomy / Q000009:adverse effects*; D004383:Duodenogastric Reflux / Q000150:complications; D004415:Dyspepsia / Q000188:drug therapy / Q000209:etiology; D005260:Female; D005756:Gastritis / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D005773:Gastroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009853:Omeprazole / Q000031:analogs & derivatives; D010865:Pilot Projects; D064750:Rabeprazole; D018709:Statistics, Nonparametric; D013392:Sucralfate / Q000627:therapeutic use*; D016896:Treatment Outcome
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000897:Anti-Ulcer Agents; D001562:Benzimidazoles; D064750:Rabeprazole; D013392:Sucralfate; D009853:Omeprazole