Rabeprazole combined with hydrotalcite is effective for patients with bile reflux gastritis after cholecystectomy.
BACKGROUND
Regardless of surgical technique, patients who have undergone cholecystectomy appear to be predisposed to the development of bile reflux gastritis.


OBJECTIVE
To assess the efficacy of rabeprazole and hydrotalcite in patients with bile reflux gastritis after cholecystectomy.


METHODS
Postcholecystectomy patients with bile reflux gastritis confirmed by endoscopy and 24 h gastric bilirubin monitoring were randomly assigned to one of four eight-week treatments: observation (group A), rabeprazole alone (group B), hydrotalcite alone (group C) and rabeprazole in combination with hydrotalcite (group D). Endoscopy and 24 h gastric bilirubin monitoring were repeated in all patients after treatment. Dyspeptic symptoms of abdominal pain, bloating, heartburn, bitter taste, endoscopic and histological finding, and biliary reflux were evaluated before and after treatment.


RESULTS
After administering medication, patient symptoms in groups B, C and D were relieved - most significantly in group D (P<0.05). There were no significant differences in endoscopic hyperemia and histological inflammation among the groups (P>0.05). However, histological activity, the number of reflux episodes and the number of reflux episodes lasting longer than 5 min were significantly decreased only in group D (P<0.05). The total per cent of bilirubin absorption (value of 0.14 units or greater) time was decreased in groups B, C and D, and most significantly in group D (P<0.05).


CONCLUSIONS
Rabeprazole combined with hydrotalcite is an effective therapeutic option in the treatment of patients with bile reflux gastritis after cholecystectomy.
Chen
Huimin
H
Department of Gastroenterology, Shanghai Renji Hospital, Shanghai Jiotong University of Medicine, Shanghai Institute of Digestive Disease, Shanghai, China.
Li
Xiaobo
X
Ge
Zhizheng
Z
Gao
Yunjie
Y
Chen
Xiaoyu
X
Cui
Yun
Y
D053799:2-Pyridinylmethylsulfinylbenzimidazoles / Q000008:administration & dosage / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000536:Aluminum Hydroxide / Q000008:administration & dosage / Q000627:therapeutic use*; D000863:Antacids / Q000008:administration & dosage / Q000627:therapeutic use; D000897:Anti-Ulcer Agents / Q000008:administration & dosage / Q000627:therapeutic use; D001655:Bile Reflux / Q000188:drug therapy* / Q000209:etiology; D001663:Bilirubin / Q000378:metabolism; D002763:Cholecystectomy / Q000009:adverse effects; D004359:Drug Therapy, Combination; D005260:Female; D005756:Gastritis / Q000188:drug therapy* / Q000209:etiology; D005773:Gastroscopy; D006801:Humans; D008276:Magnesium Hydroxide / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D064750:Rabeprazole; D013997:Time Factors
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000863:Antacids; D000897:Anti-Ulcer Agents; C010467:hydrotalcite; D064750:Rabeprazole; D000536:Aluminum Hydroxide; D008276:Magnesium Hydroxide; D001663:Bilirubin