LONG TERM MANAGEMENT OF HEMORRHAGIC ESOPHAGITIS WITH CIMETIDINE AND OMEPRAZOLE
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Abstract:
We report a patient whose severe recurrent anemia was due to overt and occult hemorrhage from peptic esophagitis. Cimetidine treatment was successful for seven years but dose reduction was followed by intractable hemorrhage which did not respond to H2-receptor antagonists. Omeprazole therapy produced dramatic remission of symptoms and anemia.Keywords:
Cimetidine
Esophagitis
Reflux esophagitis
AIM:To study the efficacy of omeprazole for therapy of reflux esophagitis in aged. METHODS:Forty-five patients(M41,F4,age 75 ± 5 a) with reflux esophagitis(SavaryMiller,grade Ⅰ, 7 cases; grade Ⅱ,31 cases;grade Ⅲ, 6 cases;grade Ⅳ,1 case) were treated with omeprazole 20 mg po,qd,for 8 wk.RESULTS:After 8 wk the clinical total effective rate was 100 %. The endoscopic healing rate was 93%.The incidence of pulmonary complication of reflux esophagitis was significantly reduced than before treatment(44 % vs 4 % ,P 0. 01).Forty-three cases of healing patients were stopped omeprazole treatment,their cumulative recurrent rates at 2,6, 12 mo were 60%, 81% and 91%,respectively. Four patients(gradeⅠ) had not recurred only. The 39 recurrent patients were treated with omeprazole of 20 mg qd again. After symptom remitting, the lower doses of omeprazole for maintaining treatment that suppresses symptom were 20 mg qd in 15 patients, 20 mg every other day in 19 patients and 20 mg each 3days in 5 patients. After maintaining treatment 3-12 mo, continually symptomatic remittent rates were 100%, 89%,and 60%, respectively. The adverse reactions of omeprazole were slight.CONCLUSION :The results showed that efficacy of omeprazole in short term and maintaining treatment for elderly reflux esophagitis is satisfactory,but recurrent rates is very high after stopping treatment.Therefore maintaining treatment is unsuitable with lower dose.
Reflux esophagitis
Esophagitis
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The aim of this study was to compare duodenal ulcer healing and symptom relief after two and four weeks treatment with omeprazole or cimetidine in groups of patients treated in general practice and as hospital out-patients. It was a randomised, double-blind, parallel group study with stratification for trial centre (hospital or GP). Endoscopy was performed at entry, after two weeks and, if unhealed at two weeks, after four weeks. All endoscopies were carried out in hospitals. In all, 189 patients were randomised (98 omeprazole, 91 cimetidine), 79 (42 per cent) of which by GPs, to either omeprazole 20 mg om (n = 41) or cimetidine 800 mg nocte (n = 38) for two to four weeks. After two weeks, ulcer healing occurred in 56 per cent (omeprazole) and 29 per cent (cimetidine) (p less than 0.05) of patients treated by GPs, and 67 per cent (omeprazole) and 36 per cent (cimetidine) (p less than 0.005) of those treated as hospital out-patients. Similar differences in healing rates were seen after four weeks. Omeprazole produces faster duodenal ulcer healing than cimetidine whether patients are treated as hospital out-patients or by GPs.
Cimetidine
Peptic
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Purpose:To observe medicine in the treatment of reflux esophagitis resulting from postoperative cardiac carcinoma. Methods:66 patients with reflux esophagitis resulging from postoperative cardiac carcinoma firstly were treated with ranitidine-motilium/cisapridc-sucralfatc combined regimen and the doses were 150 mg(bid),10-20 mg(tid),5-10 mg(tid),1 g(tid),respectively. The patients with no efficacy with combined regimen were treated ulteriorly with omeprazole, the dose was 20-40 mg(qd). Results:The clinical disappearing or improvement was attained by 51.6%(34/66) in patients treated with combined regimen, and by 93.8%(30/32) in patients (with no efficacy with combined ergimen) treated with omeprazole. Conclusions:Omeprazole could be efficacious for patients with reflux esophagitis resulting from postoperative cardiac carcinoma with no efficacy with ranitidinc-motilium/cisapridc-ulccrlmin combined regimen. Omeprazole as preferred therapy for reflux esophagitis resulting from postoperative cardiac carcinoma should be tested.
Reflux esophagitis
Regimen
Esophagitis
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We conducted a double-blind randomized study of 132 patients to determine whether the new, investigational proton-pump inhibitor, omeprazole (30 mg per day), would accelerate healing and pain relief, as compared with cimetidine (1 g per day), in patients with duodenal ulcer. After two weeks of treatment, which was completed by all patients, the healing rates were 73 per cent in the omeprazole group and 46 per cent in the cimetidine group (P less than 0.01). After four weeks of treatment, which was completed by 118 patients, the corresponding figures were 92 and 74 per cent (P less than 0.05). In the omeprazole group 55 per cent of the patients were free of pain after the first week, as compared with 40 per cent of those treated with cimetidine (P greater than 0.05). No major clinical or biochemical side effects of omeprazole or cimetidine were noted. A six-month follow-up study revealed no significant difference between the recurrence rates after omeprazole and after cimetidine treatment. In May 1984 clinical trials with omeprazole were temporarily suspended, since a study of long-term toxicity in rats had shown the development of gastric carcinoid tumors.
Cimetidine
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A single-blind randomized multicenter study was performed in 42 patients with endoscopically documented reflux esophagitis. Patients were randomly given 400 mg cimetidine q.i.d. or a suspension of 1 g sucralfate q.i.d. for a period of 8 weeks. Forty patients were evaluated after 8 weeks. Symptomatic improvement was good and was comparable in both groups. We saw side-effects in only three patients, two on sucralfate and one on cimetidine, and these did not necessitate withdrawal from the study. Endoscopy showed improvement of esophagitis in 53% and healing in 31% of patients after sucralfate treatment. With cimetidine, improvement was seen in 67% and healing in 14%. One patient on cimetidine developed a stricture during treatment. We conclude that treatment with sucralfate improves symptoms and lessens severity of reflux esophagitis and that the results with sucralfate appear to be comparable to those obtained with cimetidine. Sucralfate is a valid alternative to H2-receptor antagonist therapy.
Sucralfate
Cimetidine
Reflux esophagitis
Esophagitis
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Reflux esophagitis
Esophagitis
Transplant surgery
Esophageal disease
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To investigate the effect of Omeprazole and Chinese herbs on reflux esophagitis(RE). Methods:Thirty patients diagnosed as RE by endoscopy were given Omeprazole 20mg once a day and oral prescription of Chinese herbs. Control group of 28 cases were treated only with Omeprazole 20mg once a day. After treated for 4 weeks, the two groups were checked with endoscopy. Results: Healing rate (by endoscopy) and total effective rate of the group treated with Omeprazole together with Chinese herbs were 60.0% and 96.7%, and those of control group were 50.0% and 78.6% respectively. The difference between the two groups was significant (P0.01), Conclusion: The effect of Omeprazole and Chinese herbs on RE was better than that of simple Omeprazole.
Reflux esophagitis
Chinese herbs
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Objective To evaluate the effects of Omeprazole combined with Itopride and Almagate in the treatment of reflux esophagitis.Methods Fifty-three cases of reflux exsophagitis were randomly divided into two groups:observation group(n=27)and control group(n=26).Both groups were given Omeprazole and Itopride,and Almagate suspension was added to the observation group(n=27)15m(l3 times a day),and at the end of 8-week treatment,the curative rate was rechecked by endoscope.Results The curative rate under endoscope was 65.4% in the control group and 92.6% in the observation group,respectively,and the difference between the two groups was significan(tP0.05).Conclusion Omeprazole combined with Itopride and Almagate can effectively improve the curative effect in the treatment of reflux esophagitis.
Reflux esophagitis
Endoscope
Esophagitis
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The effect of cimetidine on healing of reflux esophagitis was investigated in a double blind study in which 16 patients received 1.6 g cimetidine/day and 20 patients placebo. After 6 weeks endoscopic healing or amelioration of the esophagitis was observed in 10 of 20 patients on placebo (50%) and in 9 of 16 patients receiving cimetidine (56%). Continuation of double blind therapy in 24 patients for another 6 weeks led to improved healing in 12 cimetidine patients but not in 10 placebo patients. In only 4 of 16 cimetidine patients there was complete healing of esophagitis at the end of the study. The cimetidine patients had fewer symptoms to a statistically significant degree after 6 and 12 weeks, respectively. It is concluded that, despite its statistically significant effects on esophagitis and reflux symptoms, cimetidine therapy of reflux disease is not satisfactory. If cimetidine therapy appears to be indicated, it should be continued for at least 12 weeks.
Cimetidine
Reflux esophagitis
Esophagitis
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Peptic ulcer disease is becoming a very common disease as it is associated with lifestyle e.g eating habits more than infection, by bacteria, H. pylori [1]. There are many treatments for the disease which are not very potent for the eradication of the disease.
A comparative study was therefore carried out with Aloe Vera, cimetidine and omeprazole to arrive at the most potent treatment drug. A total of thirty (30) male and female rats were used for the study. The Aloe Vera extract with LD50 of 1870.83 mg/kg was administered in three dosages; low, medial and high, 187.08 mg/kg, 374.42 mg/kg and 561.25 mg/kg respectively in groups (3-4) while cimetidine and omeprazole in groups V and VI respectively for 28 days. Gastric HCl increased significantly p 0.01 in groups 2, 4 and 6. Aloe Vera showed more potent healing than omeprazole and Cimetidine as there were no traces of ulceration observed in the stomach of the rats as early as 7 days of the observation treatment. However, the acid output in the Aloe Vera treated groups were not significantly reduced p>0.01 as compared to Cimetidine and omeprazole groups. But the ulceration was significantly eliminated than in the cimetidine and omeprazole treated groups. It is concluded that Aloe Vera probably acts through prostaglandin increase in its ingredient for the healing of the ulcer.
Cimetidine
Aloe Vera
Dose
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