title: Effect of omeprazole on symptoms and ultrastructural esophageal damage in acid bile reflux.
abstract: OBJECTIVE
  To value whether omeprazole could induce the healing of DIS and regression of symptoms in patients with DGER.
  
  
  METHODS
  We enrolled 15 symptomatic patients with a pathological esophageal 24-h pH-metry and bilimetry. Patients underwent endoscopy and biopsies were taken from the distal esophagus. Specimens were analyzed at histology and transmission electron microscopy (TEM). Patients were treated with omeprazole 40 mg/d for 3 mo and then endoscopy with biopsies was repeated. Patients with persistent heartburn and/or with an incomplete recovery of DIS were treated for 3 more months and endoscopy with biopsies was performed.
  
  
  RESULTS
  Nine patients had a non-erosive reflux disease at endoscopy (NERD) while 6 had erosive esophagitis (ERD). At histology, of the 6 patients with erosive esophagitis, 5 had mild esophagitis and 1 moderate esophagitis. No patients with NERD showed histological signs of esophagitis. After 3 mo of therapy, 13/15 patients (86.7%, P<0.01) showed a complete recovery of DIS and disappearance of heartburn. Of the 2 patients treated for 3 more months, complete recovery of DIS and heartburn were achieved in one.
  
  
  CONCLUSIONS
  Three or 6 mo of omeprazole therapy led to a complete regression of the ultrastructural esophageal damage in 86.7% and in 93% of patients with DGER, NERD and ERD respectively. The ultrastructural recovery of the epithelium was accompanied by regression of heartburn in all cases.
authors.affiliation: Department of Internal Medicine and Gastroenterology, Policlinico S. Orsola-Malpighi, Via Massarenti 9, 40138 Bologna, Italy. calabrese.c@med.unibo.it
authors.forename: Carlo
authors.initials: C
authors.lastname: Calabrese
authors.forename: Anna
authors.initials: A
authors.lastname: Fabbri
authors.forename: Mauro
authors.initials: M
authors.lastname: Bortolotti
authors.forename: Giovanna
authors.initials: G
authors.lastname: Cenacchi
authors.forename: Scialpi
authors.initials: S
authors.lastname: Carlo
authors.forename: Desiree
authors.initials: D
authors.lastname: Zahlane
authors.forename: Mario
authors.initials: M
authors.lastname: Miglioli
authors.forename: Giulio
authors.initials: G
authors.lastname: Di Febo
mesh_terms: D000328:Adult; D000897:Anti-Ulcer Agents / Q000008:administration & dosage*; D004847:Epithelial Cells / Q000187:drug effects / Q000473:pathology / Q000648:ultrastructure; D004942:Esophagitis, Peptic / Q000188:drug therapy* / Q000473:pathology*; D004947:Esophagus / Q000187:drug effects* / Q000473:pathology / Q000648:ultrastructure; D005260:Female; D006801:Humans; D008297:Male; D046529:Microscopy, Electron, Transmission; D008875:Middle Aged; D009092:Mucous Membrane / Q000187:drug effects / Q000473:pathology / Q000648:ultrastructure; D009853:Omeprazole / Q000008:administration & dosage*
chemical_list: D000897:Anti-Ulcer Agents; D009853:Omeprazole