Effect of omeprazole on symptoms and ultrastructural esophageal damage in acid bile reflux.
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.
Calabrese
Carlo
C
Department of Internal Medicine and Gastroenterology, Policlinico S. Orsola-Malpighi, Via Massarenti 9, 40138 Bologna, Italy. calabrese.c@med.unibo.it
Fabbri
Anna
A
Bortolotti
Mauro
M
Cenacchi
Giovanna
G
Carlo
Scialpi
S
Zahlane
Desiree
D
Miglioli
Mario
M
Di Febo
Giulio
G
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*
D000897:Anti-Ulcer Agents; D009853:Omeprazole