The Role of Proton Pump Inhibitors in the Treatment of Barrett,s Esophagus
Session
Medicine and Nursing
Description
Background: Gastroesophageal Reflux Disease (GERD) is accepted as an exemplary etiological factor for Barrett's esophagus (BE), which is a major predisposition to esophageal adenocarcinoma. Due to the risk of chronic heartburn progressing to Barrett's, endoscopy every five years is recommended for people with chronic heartburn, or who take drugs for chronic GERD. The proton pump inhibitors (PPI) class is the most potent type of acid suppression therapy.
Aim: To evaluate the efficacy of PPI in the regression of histopathological changes in patients with Barrett's esophagus
Methods and patients: in this prospective treatment research, 50 patients were included, of which 40 were with intestinal metaplasia (IM) and 10 patients with low-grade dysplasia (LGD). All these cases with BE, have been verified histopathologically in two histopathological centers: Pristina and Skopje. Eventual regression was evidenced after 2 years of PPI treatment at maximum doses, also through histoaptological verification. The data have been statistically processed and presented in the respective tables and graphs.
Results: Of the 50 patients with BE according to histopathological type 40 or 80.0% were IM, 10 or 20% were LGD (low grade dysplasia) and there was no case of HGD (high grade dysplasia). Of the 40 IM patients at the beginning of treatment, after two years of treatment only 20 or 50.0% were IM, 4 or 10.0% were LGD and 16 or 40.0% were NERD ((Nonerosive reflux disease). Of the 10 LGD field patients two years only 5 or 50.0% were LGD, 2 or 20.0% had IM and 3 or 30.0% had NERD. According to the histopathological type and the presence of disease regression in patients with BE, we did not receive a significant difference (Fisher Exact test, P = 0.487). 40.0% of patients in the IM group and 50.0% of patients in the LGD group had regression.
Conclusion: The efect of PPI in regression of cases with LGD shows that this microscopic evidence was not ireversibile. We found that PPI therapy appeared beneficial in preventing the development of low-grade dysplasia in Barrett’s oesophagus.
Keywords:
Intestinal metaplasia, LGD, endoscopy, regression
Proceedings Editor
Edmond Hajrizi
ISBN
978-9951-550-50-5
Location
UBT Kampus, Lipjan
Start Date
29-10-2022 12:00 AM
End Date
30-10-2022 12:00 AM
DOI
10.33107/ubt-ic.2022.149
Recommended Citation
Gashi, Zaim; Gashi, Arjeta; and Sherifi, Fadil, "The Role of Proton Pump Inhibitors in the Treatment of Barrett,s Esophagus" (2022). UBT International Conference. 150.
https://knowledgecenter.ubt-uni.net/conference/2022/all-events/150
The Role of Proton Pump Inhibitors in the Treatment of Barrett,s Esophagus
UBT Kampus, Lipjan
Background: Gastroesophageal Reflux Disease (GERD) is accepted as an exemplary etiological factor for Barrett's esophagus (BE), which is a major predisposition to esophageal adenocarcinoma. Due to the risk of chronic heartburn progressing to Barrett's, endoscopy every five years is recommended for people with chronic heartburn, or who take drugs for chronic GERD. The proton pump inhibitors (PPI) class is the most potent type of acid suppression therapy.
Aim: To evaluate the efficacy of PPI in the regression of histopathological changes in patients with Barrett's esophagus
Methods and patients: in this prospective treatment research, 50 patients were included, of which 40 were with intestinal metaplasia (IM) and 10 patients with low-grade dysplasia (LGD). All these cases with BE, have been verified histopathologically in two histopathological centers: Pristina and Skopje. Eventual regression was evidenced after 2 years of PPI treatment at maximum doses, also through histoaptological verification. The data have been statistically processed and presented in the respective tables and graphs.
Results: Of the 50 patients with BE according to histopathological type 40 or 80.0% were IM, 10 or 20% were LGD (low grade dysplasia) and there was no case of HGD (high grade dysplasia). Of the 40 IM patients at the beginning of treatment, after two years of treatment only 20 or 50.0% were IM, 4 or 10.0% were LGD and 16 or 40.0% were NERD ((Nonerosive reflux disease). Of the 10 LGD field patients two years only 5 or 50.0% were LGD, 2 or 20.0% had IM and 3 or 30.0% had NERD. According to the histopathological type and the presence of disease regression in patients with BE, we did not receive a significant difference (Fisher Exact test, P = 0.487). 40.0% of patients in the IM group and 50.0% of patients in the LGD group had regression.
Conclusion: The efect of PPI in regression of cases with LGD shows that this microscopic evidence was not ireversibile. We found that PPI therapy appeared beneficial in preventing the development of low-grade dysplasia in Barrett’s oesophagus.