Role of Omeprazole in the Prevention and Treatment of Postendoscopic
Esophageal Variceal Sclerotherapy Induced Ulcerations
Clinical Question
Will omeprazole treatment prevent ulcer formation or speed the healing of
ulcers induced by endoscopic sclerotherapy for esophageal varices?
Clinical Bottom Line
- There is no statistically significant difference in the risk of ulcer
development or healing of ulcers with or without the use of omeprazole in
patients undergoing endoscopic sclerotherapy for esophageal ulcers.
The Evidence
|
Omeprazole no. (%) |
Placebo |
p-value* |
| Esophageal ulcer development |
16 (76%) |
18 (78%) |
NSS** |
| Total number of ulcers/group |
51 |
55 |
NSS |
| Mean number of ulcers/patient |
2.43 |
2.39 |
NSS |
| Number of ulcers healing within 7 days |
19 (37%) |
26 (47%) |
NSS |
| Healing within 7 - 14 days |
30 (59%) |
24 (45%) |
NSS |
| Healing > 14 days |
2 (4%) |
5 (8%) |
NSS |
| Esophageal strictures |
2 |
1 |
NSS |
- * p-values not reported in the article.
- ** Not statistically significant.
Comments
- Valid according to the JAMA User's guide on Therapy articles.
- This was a small study (N=47), only three lost to follow-up, but all
patients were accounted for.
- No confidence intervals were provided, although these are probably not a
necessity since none of the differences between groups were statistically
significant by the Chi-square and one-sided Student's t-test.
- Despite being a small study, this is fair evidence that treating patients
with omeprazole who've undergone endoscopic variceal sclerosis does not result
in any added benefit. Given the cost of omeprazole, this reviewer cannot
recommend it's routine use in these situations.
APPRAISED BY: Patrick J. Sousa, MD
DATE: October 25, 1996
Garg PK, et al. Role of Omeprazole in Prevention and Treatment of
Postendoscopic Variceal Sclerotherapy Esophageal Complications. Dig Dis Sci,
1995;40(7):1569-1574.
