Acute therapy with intravenous omeprazole on caustic esophageal injury: a prospective case series

Abstract

The ingestion of caustic substances may result in significant esophageal injury. There is no standard treatment protocol for esophageal injury and most patients are treated with a proton pump inhibitor or H2 antagonist. However, there is no clinical study evaluating the efficacy of omeprazole for caustic esophageal injury. A prospective study of 13 adult patients (>18 years of age) who were admitted to our hospital for caustic ingestion between May 2010 and June 2010 was conducted. Mucosal damage was graded using a modified endoscopic classification described by Zargar et al. Patients were treated with a proton pump inhibitor and maintained without oral intake until their condition was considered stable. Patients received omeprazole 80 mg in bolus IV, followed by continuous infusion of 8 mg/hour for 72 hours. A control endoscopy was performed 72 hours after admission. There was significant difference regarding endoscopic healing between the before and after omeprazole infusion (P = 0.004). There was no hospital mortality at the follow-up. Omeprazole may effectively be used in the acute phase treatment of caustic esophagus injuries.

Gastrointestinal system lesions in children due to the ingestion of alkali andacid corrosive substances

“…H 2 receptor blockers and proton pump inhibitors have been used to either prevent or treat gastrointestinal ulcers for a long time, even though no studies have been performed on their use for the treatment of caustic damage. Only one study (21) proposed that omeprazole may be efficient for treating corrosive burn injuries to the esophagus.…”

Evaluation and Management of Caustic Injuries from Ingestion of Acid or Alkaline Substances

“…In addition, an intravenous (IV) line must be kept for fluid resuscitation in patients with hypotension. To prevent stress ulcers and additional damage to the esophagus from the regurgitated gastric acid, IV proton pump inhibitors can be administered 31. If patients experience pain, it should be controlled with adequate administration of narcotic anesthetics.…”

A Case Series on Severe Corrosive Injury of Upper Gastrointestinal Tract

“…Endoscopy and even dilatation have been performed without consequences from 5 to 15 d after corrosive ingestion [11]. To date, the efficacy of proton-pump inhibitors and H2 blockers in minimizing esophageal injury by suppressing acid reflux has not been proven, though an impressive endoscopic healing after IV omeprazole infusion has been observed in a small prospective study [12].…”