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World Journal of Surgery

Published in:

01-02-2008

Proton Pump Inhibitors Relieve and Prevent Symptoms Related to Gastric Acidity after Esophagectomy

Authors: Manabu Okuyama, Satoru Motoyama, Kiyotomi Maruyama, Kenji Sasaki, Yusuke Sato, Jun-ichi Ogawa

Published in: World Journal of Surgery | Issue 2/2008

Abstract

Background

Denervated stomach used as an esophageal substitute after esophagectomy often retains or spontaneously recovers acid production. The aims of the present study were to assess the relationship between esophageal acid exposure or gastric acidity and reflux-related symptoms after esophagectomy, and to assess the ability of proton pump inhibitors (PPIs) to relieve gastroesophageal reflux-related symptoms.

Methods

Forty-four patients underwent esophageal and gastric 24-h pH monitoring early after esophagectomy with gastric reconstruction. Initially, patients with both gastric acidity and reflux symptoms were treated with PPIs (Treatment group), then all patients with gastric acidity, whether symptomatic or not, were treated (Prevention group). Reflux-related symptoms were correlated with esophageal acid exposure and postoperative gastric acidity. Gastric acidity was then correlated with serum anti-Helicobacter pylori immunoglobulin G (IgG) titers and preoperative endoscopic findings

Results

Sixteen patients (36.4%) reporting reflux and showing gastric acid production were treated with PPIs, which provided relief to 13 (81.3%). Although symptoms did not correlate with the esophageal acid exposure, postoperative gastric acidity was significantly greater among patients who were symptomatic than among those who were not. Overall, acid production was lower in older patients (> 64 years of age), although older patients who were H. pylori-negative and without chronic atrophic gastritis also showed high levels of gastric acidity.

Conclusions

Proton pump inhibitors should be administered prophylactically early after esophagectomy to relieve and prevent reflux-related symptoms. Candidates for preventive therapy include those less than 64 years of age or older patients who are H. pylori-negative and without chronic atrophic gastritis.

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Title: Proton Pump Inhibitors Relieve and Prevent Symptoms Related to Gastric Acidity after Esophagectomy
Authors: Manabu Okuyama
Satoru Motoyama
Kiyotomi Maruyama
Kenji Sasaki
Yusuke Sato
Jun-ichi Ogawa
Publication date: 01-02-2008
Publisher: Springer-Verlag
Published in: World Journal of Surgery / Issue 2/2008
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-007-9325-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Proton Pump Inhibitors Relieve and Prevent Symptoms Related to Gastric Acidity after Esophagectomy

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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