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Regression of columnar‐lined (Barrett’s) oesophagus with omeprazole 40 mg daily: results of 5 years of continuous therapy
Author(s) -
C Wilkinson,
Biddlestone,
Gore,
Shepherd
Publication year - 1999
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1046/j.1365-2036.1999.00593.x
Subject(s) - omeprazole , medicine , dysplasia , gastroenterology , endoscopy , barrett's oesophagus , malignant transformation , logistic regression , pathology , cancer , adenocarcinoma
Background : We have previously reported the effect of 2 years of omeprazole 40 mg daily on columnar‐lined (Barrett’s) oesophagus (CLO). Aims : In the present study, follow‐up has been extended to 5 years to assess the macroscopic and microscopic effects of continuing therapy. Patients and methods : The 23 patients have been followed for up to a further 3 years. Endoscopy with multiple biopsies was performed at the end of years 3, 4 and 5. Results : Although there had been a statistically significant regression in the length of CLO after 2 years, there was no overall further measurable change after 5 years. However, one patient showed complete macroscopic and microscopic regression. The number and size of macroscopic squamous islands within the CLO continued to increase, and there was a further increase in microscopic squamous re‐epithelialization of surface mucosa, gland ducts and Barrett’s gland tissue. Low‐grade dysplasia was found consistently in one patient in biopsies taken up to the end of year 3 but it could not be detected thereafter. Conclusions : Omeprazole 40 mg daily appears to have beneficial effects on CLO, although it rarely induces a complete regression. Whether the benefits will reduce the risk of malignant transformation is unknown.