A randomized blinded comparison of omeprazole and ranitidine in the treatment of chronic esophageal stricture secondary to acid peptic esophagitis

Stephen E. Silvis, Mahnaz Farahmand, June A. Johnson, Howard J. Ansel, Samuel B. Ho

Research output: Contribution to journalArticlepeer-review

39 Scopus citations

Abstract

Background: Esophageal strictures due to gastroesophageal reflux disease are often resistant to medical therapy and require repeated dilation procedures. Our aim was to compare the efficacy of therapy with omeprazole (20 mg/day) to ranitidine (150 mg twice daily) in the treatment of chronic esophageal strictures. Methods: Thirty-three patients with chronic esophageal stricture disease (mean length of prior treatment 50.9 months) were entered into a randomized blinded trial. The majority (88%) of the patients had received multiple prior esophageal dilations (mean, 7.9 per patient). Endoscopy and barium esophagograms were performed initially and at the end of 10 months. Symptoms were considered every 2 months and dilations performed as needed. The patient groups were equivalent. Results: One patient in each group was subsequently lost to follow-up. No significant differences were seen in symptom improvement or need of dilation. At the final endoscopy, 8 of 17 (47%) patients receiving ranitidine had residual erosions or ulceration, compared with 1 of 14 (7%) patients receiving omeprazole (p>0.2). All patients receiving ranitidine had persistent strictures, whereas 8 of 14 (57.1%) patients receiving omeprazole had radiographic and endoscopic resolution of their strictures (p<0.004). Conclusion: These data further emphasize the need for vigorously treating esophagitis in patients with acid peptic strictures.

Original languageEnglish (US)
Pages (from-to)216-221
Number of pages6
JournalGastrointestinal endoscopy
Volume43
Issue number2 PART 2
DOIs
StatePublished - 1996

Bibliographical note

Funding Information:
This work was supported by the Research Service of the VA Medical Center and in part by a grant from Merck, Inc.

Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.

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