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

Mahawongkajit, Prasit; Tomtitchong, Prakitpunthu; Boochangkool, Nuttorn; Mingmalairak, Chatchai; Awsakulsutthi, Surajit; Havanond, Chittinad

doi:10.1007/s00464-020-07707-0

Cited by 10 publications

(8 citation statements)

References 37 publications

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“…Causes of corrosive ingestion are accidental and suicide. 1,[8][9][10][11] The socioeconomic and psychological factors are crucial intentional motivation 22,23 in the COVID-19 pandemic, the outbreak of coronavirus impacts global mental health. 14,15 Most of the government strategies applied the "Lockdown situation" to manage the COVID-19 pandemic worldwide, and Thailand was affected by creating a significant sudden change in economic conditions and human way of life.…”

Section: Discussionmentioning

confidence: 99%

“…Corrosive ingestion is a global and serious public health challenge and is a common form of self-harm and its incidence is more common in developing countries, including Thailand, compared to developed countries. [1][2][3][4][5][6][7][8][9] Common ingested corrosives include acids or bases. The causes of corrosive ingestion vary by age.…”

Section: Introductionmentioning

confidence: 99%

“…Common reasons for intentional ingestion include stress and attempted suicide. 1,[8][9][10][11] Currently, many research studies focus on the risk factors for corrosive ingestion 12,13 but, to our knowledge, there are no studies examining the effect of the COVID-19 pandemic. Since January 2020, the outbreak and global spread of COVID-19 have impacted global mental health, daily activities, and economies, including Thailand, where the government adopted an early strategy of "Lockdown."…”

Section: Introductionmentioning

confidence: 99%

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The Effect of the COVID-19 on Corrosive Ingestion in Thailand

Thongchuam¹,

Mahawongkajit²,

Kanlerd³

2021

OAEM

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the outbreak of COVID-19 coronavirus has impacted global mental health, daily activities, and economies, including Thailand. The essential strategy is the disease-preventing measure of "lockdown." Corrosive ingestion is one of the most common forms of self-harm and problems worldwide. This study aimed to evaluate the effect of corrosive ingestion in the COVID-19 situation. Methods: This was a retrospective study of adult patients (≥18y) who had ingested corrosives and been admitted to surgical department, Thammasat University Hospital between June and December 2019 (pre-COVID-19) and January to June 2020 (COVID-19 period) and compared the epidemiological and clinical features between these two groups. Results: Nine and 20 patients were admitted in the pre-COVID-19 and COVID-19 periods, for an increase of 122%; males numbered 15. A minority of ingestions, 8/29, were intentional of which 7 were in the COVID-19 period. The Zargar classification showed a trend towards more gastric injury in the COVID-19 vs pre-COVID-19 periods: 8/17 vs 1/9 (p=0.09). Because of the endoscopic grade 0 in stomach was significantly higher in pre-COVID-19 than COVID-19 case (pre-COVID-19; 8 patients (88.9%), COVID-19; 9 patients (45%); p value 0.011). Conclusion:Data from this study suggest increasing trends of corrosive ingestion and greater gastric injury during the COVID-19 period.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Effect of the COVID-19 on Corrosive Ingestion in Thailand

Thongchuam¹,

Mahawongkajit²,

Kanlerd³

2021

OAEM

Self Cite

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“…We chose to follow guidelines for Grade 2B erosions that include placing an NG tube and monitoring inpatient for at least 48 h. We also administered antibiotic prophylaxis and a proton pump inhibitor (PPI) to allow for proper healing of the esophageal mucosa. PPIs have been shown to promote mucosal healing and decrease the risk of stricture formation in the setting of corrosive esophageal injury [ 18 , 19 ]. While steroids have been suggested to prevent stricture formation, there is a lack of supporting evidence in the literature for this practice [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

Endoscopic Evaluation for Stricture Formation Post Button Battery Ingestion

Bulna

Fifi

2021

Pediatric Reports

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Every year, there are over 3300 ingestions of button batteries, mostly by young children. Initial presentation of button battery ingestion may be nonspecific, with a delay in diagnosis and removal resulting in increased risk of complications. We present the case of a five-year-old female who presented with vomiting following unwitnessed button battery ingestion. The battery was impacted in the middle esophagus for at least six hours. Endoscopy was performed for immediate removal and showed a Grade 2B erosion, warranting nasogastric tube placement. The patient remained asymptomatic following discharge and had a barium swallow that was read as normal. However, a repeat endoscopy one month later visualized stricture formation at the previous battery injury site. This case highlights the importance of both clinician and parent awareness of button battery ingestion and demonstrates that endoscopy provides the most accurate assessment of esophageal injury and complication development, even in asymptomatic patients.

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“…Steroids cause severe adverse side effects such as esophageal candidiasis, gastric ulcer, ethmoiditis, osteomyelitis, and osteoporosis [56][57][58]. Recent studies have demonstrated that omeprazole with proton pump inhibitor activity could enhance healing, reduce stricture, and reduce the short-term risk of developing esophageal stricture in patients with 2b and 3a corrosive injuries [9,[59][60][61]. However, further studies of omeprazole are needed to corroborate these findings (Figure 2).…”

Section: Stricturementioning

confidence: 97%

Acute Management in Corrosive Ingestion

Mahawongkajit¹

2022

Dysphagia - New Advances

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Corrosive ingestion is an important health problem and medical emergency worldwide. It occurs by accident or by intention. Acids cause coagulation necrosis, and alkalis cause liquefaction necrosis. In the acute period, stabilization of the patient is most important. Airway assessment and prompt management are a priority for severe cases. Caustic substance reflux into the esophagus resulting in further damage should be prevented. The initial evaluation should be performed by endoscopy and graded according to the Zargar classification. Computed tomography (CT) should be used to assess injury to the esophagus because CT is non-invasive. For Zargar 3b injuries, views from both endoscopy and CT scans should be considered. Post-corrosive esophageal stricture is a complication that responds poorly to treatment. Research and development for stricture prevention are ongoing, especially for Zargar 2b and 3a cases.

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

Cited by 10 publications

References 37 publications

The Effect of the COVID-19 on Corrosive Ingestion in Thailand

The Effect of the COVID-19 on Corrosive Ingestion in Thailand

Endoscopic Evaluation for Stricture Formation Post Button Battery Ingestion

Acute Management in Corrosive Ingestion

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