Wilkinson S P, Biddlestone L, Gore S, Shepherd N A
Gloucestershire Royal Hospital, Great Western Road, Gloucester, UK.
Aliment Pharmacol Ther. 1999 Sep;13(9):1205-9. doi: 10.1046/j.1365-2036.1999.00593.x.
We have previously reported the effect of 2 years of omeprazole 40 mg daily on columnar-lined (Barrett's) oesophagus (CLO).
In the present study, follow-up has been extended to 5 years to assess the macroscopic and microscopic effects of continuing therapy.
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.
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.
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.
