Bt. Cooper et al., CONTINUOUS TREATMENT WITH OMEPRAZOLE 20 MG DAILY FOR UP TO 6 YEARS INBARRETTS-ESOPHAGUS, Alimentary pharmacology & therapeutics, 12(9), 1998, pp. 893-897
Background: Because of the malignant potential of Barrett's oesophagus
, an aim of treatment is to cause the columnar epithelium to regress.
A logical approach is to decrease acid reflux which is an important ae
tiological factor in Barrett's oesophagus. Treatment with omeprazole 2
0-80 mg over 1-3 years has yielded conflicting but largely disappointi
ng results. Aim: To determine if treatment of Barrett's oesophagus wit
h omeprazole 20 mg daily for up to 6 years can cause regression of the
Barrett's epithelium. Patients and Methods: Forty-seven patients with
Barrett's oesophagus were treated in an open prospective study, Nine
patients were treated for 2 years, 12 for 3 years, 10 for 4 years, eig
ht for 5 years and eight for 6 years. Patients were endoscoped at 1-2-
year intervals and endoscoped at the end of the treatment period. Resu
lts: No significant shortening of the length of the Barrett's segment
was seen during any treatment period, although omeprazole controlled r
eflux symptoms and was well tolerated. Macroscopic squamous islands ap
peared in 55% of patients, mostly in the first 2-3 years although in f
ive patients they appeared later in treatment. Conclusion: Treatment o
f Barrett's oesophagus with omeprazole 20 mg daily for periods of up t
o 6 years did not cause regression in the length of the Barrett's segm
ent, but it did lead in over half of the patients to partial re-epithe
lialization in the form of squamous islands.