EFFECT OF SUCRALFATE GRANULES IN SUSPENSION ON ENDOSCOPIC VARICEAL SCLEROTHERAPY INDUCED ULCER - ANALYSIS OF THE FACTORS DETERMINING ULCER HEALING

Oesophageal ulcers commonly occur after endoscopic variceal sclerother apy and usually cause complications and a delay in further sclerothera py. The aims of this study are to investigate the effect of sucralfate granules in suspension on the treatment of endoscopic variceal sclero therapy induced ulcer and analyse the factors determining the ulcer he aling. Fifty-two patients with oesophageal variceal bleeding received elective endoscopic variceal sclerotherapy. After endoscopically prove d oesophageal ulcers, they were randomized to receive either sucralfat e granules in suspension (n = 22) or antacid (n = 23). Follow-up endos copy was performed weekly. Ulcer healing rates were compared between t he groups using the log-rank test. Forty-one ulcers receiving sucralfa te and 48 ulcers receiving antacid treatment were evaluated. The clini cal characteristics of the ulcers were similar in both groups. The ulc ers in patients receiving sucralfate healed faster than those receivin g antacid (P<0.02). On analysis of factors affecting ulcer healing, ul cers smaller than 1 cm(2) (n = 59) appeared to heal faster than those larger than 1 cm(2) (n = 30; P = 0.059) and shallow ulcers (n = 46) he aled faster than deep ulcers (n = 43; P<0.001). On multifactorial anal ysis, ulcer depth was the only factor determining ulcer healing. The u lcer healing effects of sucralfate became more prominent when the ulce r was larger than 1.0cm(2) (1.7+/-0.6 weeks vs 2.3+/-0.6 weeks, P = 0. 011) and deep (1.7+/-0.7 weeks vs 2.5+/-1.0 weeks, P = 0.013) when com pared with those receiving antacid. Sucralfate granules in suspension speed the healing of endoscopic variceal sclerotherapy induced ulcer, especially deep and large ulcers.