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Randomized Controlled Trial
. 2021 Jun;35(6):2759-2764.
doi: 10.1007/s00464-020-07707-0. Epub 2020 Jun 15.

A prospective randomized controlled trial of omeprazole for preventing esophageal stricture in grade 2b and 3a corrosive esophageal injuries

Prasit Mahawongkajit  1 , Prakitpunthu Tomtitchong  2 , Nuttorn Boochangkool  2 , Chatchai Mingmalairak  2 , Surajit Awsakulsutthi  2 , Chittinad Havanond  2
Affiliations
Randomized Controlled Trial

A prospective randomized controlled trial of omeprazole for preventing esophageal stricture in grade 2b and 3a corrosive esophageal injuries

Prasit Mahawongkajit et al. Surg Endosc. 2021 Jun.

Abstract

Objectives: Esophageal stricture is a significant complication of grade 2b and 3a esophageal injuries and causes much patient suffering. Preventing strictures would be beneficial to patients but there are currently no proven effective drugs. This study aimed to evaluate the effect of omeprazole for preventing esophageal stricture in adults with grade 2b and 3a corrosive esophageal injuries.

Methods: This study was an open single-center prospective randomized controlled trial that took place from April 2018 to January 2020. Patients were randomized to standard treatment or 80 mg/day intravenously × 3 days followed by 40 mg/day orally for 4 weeks. They were endoscoped at baseline and 4 weeks post discharge. Strictures were confirmed radiologically.

Results: 20 patients were enrolled: 15 with grade 2b and five with grade 3a injuries. Standard care and omeprazole groups numbered 10 each. At 1 month, seven and two patients developed strictures in the standard and omeprazole groups, respectively, p = 0.024, for a risk reduction of 71.4%.

Conclusions: Omeprazole reduced the risk of short-term developing esophageal strictures following grade 2b and 3a corrosive esophageal injuries. Larger studies are needed to reconfirm this finding. Thai Clinical Trials Registry (TCTR) number TCTR20190504001.

Keywords: Caustic injury; Corrosive esophageal injury; Esophageal stricture; Omeprazole.

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