Acute therapy with intravenous omeprazole on caustic esophageal injury: a prospective case series

Dis Esophagus. 2013 Jan;26(1):22-6. doi: 10.1111/j.1442-2050.2011.01319.x. Epub 2012 Feb 14.

Abstract

The ingestion of caustic substances may result in significant esophageal injury. There is no standard treatment protocol for esophageal injury and most patients are treated with a proton pump inhibitor or H2 antagonist. However, there is no clinical study evaluating the efficacy of omeprazole for caustic esophageal injury. A prospective study of 13 adult patients (>18 years of age) who were admitted to our hospital for caustic ingestion between May 2010 and June 2010 was conducted. Mucosal damage was graded using a modified endoscopic classification described by Zargar et al. Patients were treated with a proton pump inhibitor and maintained without oral intake until their condition was considered stable. Patients received omeprazole 80 mg in bolus IV, followed by continuous infusion of 8 mg/hour for 72 hours. A control endoscopy was performed 72 hours after admission. There was significant difference regarding endoscopic healing between the before and after omeprazole infusion (P = 0.004). There was no hospital mortality at the follow-up. Omeprazole may effectively be used in the acute phase treatment of caustic esophagus injuries.

MeSH terms

  • Adult
  • Burns, Chemical / drug therapy*
  • Burns, Chemical / pathology
  • Caustics / poisoning*
  • Cohort Studies
  • Emergency Treatment / methods
  • Esophageal Diseases / chemically induced*
  • Esophageal Diseases / drug therapy*
  • Esophagoscopy / methods
  • Esophagus / drug effects
  • Esophagus / injuries
  • Female
  • Follow-Up Studies
  • Humans
  • Infusions, Intravenous
  • Male
  • Middle Aged
  • Mucous Membrane / drug effects
  • Mucous Membrane / pathology
  • Omeprazole / administration & dosage*
  • Prospective Studies
  • Proton Pump Inhibitors / administration & dosage*
  • Risk Assessment
  • Treatment Outcome
  • Young Adult

Substances

  • Caustics
  • Proton Pump Inhibitors
  • Omeprazole