title: Efficacy of a proton pump inhibitor given in the early postoperative period to relieve symptoms of hiatal hernia after open heart surgery.
abstract: OBJECTIVE
  To evaluate the efficacy of a proton pump inhibitor, we retrospectively reviewed patients who underwent gastric fiberscopy (GFS) in the early phase after cardiac surgery.
  
  
  METHODS
  The subjects were 103 patients who underwent GFS for poor appetite, gastric pain, heartburn, or hematemesis after cardiac surgery. We divided the patients into two groups: group I consisted of 49 patients who received an H2-receptor antagonist (ranitidine hydrochloride 300 mg/day), and group II consisted of 54 patients who received a proton pump inhibitor (PPI; sodium rabeprazole 10 mg/day) as prophylactic treatment. The incidence of upper gastrointestinal (GI) disease was compared in the two groups.
  
  
  RESULTS
  Gastric fiberscopy confirmed that 82.5% of the patients had type I hiatal hernia. The incidences of gastric pain and heartburn were significantly higher in group I (12.2% and 83.7%) than in group II (0% and 37.0%). Moreover, gastric bleeding occurred in two patients from group I, one [corrected] of whom died of coagulopathy. The incidences of hemorrhagic gastritis, active ulcer, and reflux esophagitis were significantly higher in group I than in group II, at 22.4%, 22.4%, and 24.5% vs 1.9%, 0%, and 7.4%.
  
  
  CONCLUSIONS
  Early postcardiotomy GFS confirmed a high incidence of type I hiatal hernia. However, the proton pump inhibitor given in the early postoperative period proved more effective than the H2-receptor antagonist for relieving GI symptoms and preventing upper GI disorders after cardiac surgery.
authors.affiliation: Department of Cardiovascular Surgery, Nihon University School of Medicine, 30-1 Ooyaguchi, Kamimachi, Itabashi-ku, Tokyo, 173-8610, Japan.
authors.forename: Mitsumasa
authors.initials: M
authors.lastname: Hata
authors.forename: Motomi
authors.initials: M
authors.lastname: Shiono
authors.forename: Hisakuni
authors.initials: H
authors.lastname: Sekino
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Furukawa
authors.forename: Akira
authors.initials: A
authors.lastname: Sezai
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Iida
authors.forename: Isamu
authors.initials: I
authors.lastname: Yoshitake
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Hattori
authors.forename: Shinji
authors.initials: S
authors.lastname: Wakui
authors.forename: Makoto
authors.initials: M
authors.lastname: Taoka
authors.forename: Nanao
authors.initials: N
authors.lastname: Negishi
authors.forename: Yukiyasu
authors.initials: Y
authors.lastname: Sezai
mesh_terms: D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001562:Benzimidazoles / Q000627:therapeutic use*; D006348:Cardiac Surgical Procedures / Q000009:adverse effects* / Q000379:methods; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005764:Gastroesophageal Reflux / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000517:prevention & control; D006551:Hernia, Hiatal / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009853:Omeprazole / Q000031:analogs & derivatives* / Q000627:therapeutic use; D017060:Patient Satisfaction; D011182:Postoperative Care; D011336:Probability; D054328:Proton Pump Inhibitors; D064750:Rabeprazole; D011899:Ranitidine / Q000627:therapeutic use*; D018570:Risk Assessment; D016896:Treatment Outcome
chemical_list: D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D001562:Benzimidazoles; D054328:Proton Pump Inhibitors; D064750:Rabeprazole; D011899:Ranitidine; D009853:Omeprazole