Pharmacotherapy of an ulcer in Barrett's esophagus: carbenoxalone and cimetidine.

A 70-year old man is described who had specialized columnar epithelium in the esophagus up to the upper esophageal sphincter, 19 cm from the incisor teeth. The patient had a small sliding hiatus hernia but the lower esophageal sphincter was located at 39-41 cm. Above the sphincter the patient had large peptic ulcers which failed to heal after 1 year of a conventional antireflex regimen. Carbenoxalone sodium administration led to healing in 3 months. However, the ulcers recurred after discontinuation of the drug. On a second attempt carbenoxalone effected modest healing but was stopped because of hypertension and hypokalemia. Cimetidine therapy led to complete healing of the the ulcer within a month. The authors concluded that both carbenoxalone and cimetidine are useful in the treatment of an ulcer in Barrett's esophagus. However, cimetidine may be more rapidly effective and does not produce dangerous side effects.