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

• Published in: Diseases of the esophagus Vol. 26; no. 1; pp. 22 - 26
• Main Authors: Çakal, B., Akbal, E., Köklü, S., Babalı, A., Koçak, E., Taş, A.
• Format: Journal Article
• Language: English
• Published: Malden, USA Blackwell Publishing Inc 01-01-2013
• Subjects: Adult; Burns, Chemical - drug therapy; Burns, Chemical - pathology; caustic esophageal injury; 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; Omeprazole - administration & dosage; Prospective Studies; Proton Pump Inhibitors - administration & dosage; Risk Assessment; treatment; Treatment Outcome; Young Adult
• ISSN: 1120-8694; 1442-2050
• DOI: 10.1111/j.1442-2050.2011.01319.x

SUMMARY
The ingestion of caustic substances may result in significant esophageal injury. There is no standard treatment protochol 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.