Omeprazole is more effective than a histamine H2-receptor blocker for maintaining a persistent elevation of gastric pH after colon resection for cancer.
BACKGROUND
An assessment was made of the change and the effect of a histamine H(2)-receptor blocker (H(2)-blocker) or omeprazole on gastric pH after surgery.


METHODS
Eighty patients who underwent colon resection for colorectal cancer were divided into groups of 20. Group I received neither H(2)-blocker nor omeprazole. Group II received cimetidine hydrochloride 1,200 mg daily, group III received ranitidine hydrochloride 200 mg daily, group IV received omeprazole 40 mg twice daily for 5 days. Gastric juice was measured preoperatively and then twice daily until the fifth postoperative day.


RESULTS
The gastric pH decreased after surgery. The gastric pH increased on the first postoperative day after the administration of H(2)-blockers (P <0.001), but started to decrease on the second postoperative day. The gastric pH increased and remained high throughout the study period for the omeprazole group (P <0.001).


CONCLUSIONS
The administration of an H(2)-blocker can significantly elevate the gastric pH value for patients after resection of colorectal cancer, but only lasts for 24 to 48 hours. Omeprazole is more effective than an H(2)-blocker at maintaining a persistent elevation of gastric pH.
Hsu
Tzu-Chi
TC
Colon and Rectal Surgery, Department of Surgery, Mackay Memorial Hospital, Taipei, Taiwan. tzuchi@ms2.mmh.org.tw
Su
Chiu-Feng
CF
Leu
Shu-Ching
SC
Huang
Pi-Chen
PC
Wang
Tsang-En
TE
Chu
Cheng-Hsin
CH
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000897:Anti-Ulcer Agents / Q000627:therapeutic use*; D002927:Cimetidine / Q000627:therapeutic use*; D003110:Colonic Neoplasms / Q000601:surgery*; D005260:Female; D005745:Gastric Acidity Determination; D005753:Gastric Mucosa / Q000378:metabolism*; D006635:Histamine H2 Antagonists / Q000627:therapeutic use*; D006801:Humans; D006863:Hydrogen-Ion Concentration / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D009853:Omeprazole / Q000627:therapeutic use*; D011899:Ranitidine / Q000627:therapeutic use*; D013270:Stomach / Q000187:drug effects
D000897:Anti-Ulcer Agents; D006635:Histamine H2 Antagonists; D002927:Cimetidine; D011899:Ranitidine; D009853:Omeprazole