The efficiency of sucralfate in corrosive esophagitis: A randomized, prospective study

Gümürdülü, Yüksel; Karakoç, Emre; Kara, Banu; Taşdoğan, Burçak Evren; Parsak, Cem Kaan; Sakman, Gürhan

doi:10.4318/tjg.2010.0040

Cited by 25 publications

(10 citation statements)

References 25 publications

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“…In addition, sucralfate deposited in a nonacidified esophagus was rapidly cleared and poorly timed to provide protection against reflux injury . Sucralfate decreased the frequency of stricture formation in human patients with advanced corrosive esophagitis, and topical sucralfate was effective for post‐tonsillectomy analgesia in people . No controlled studies have been completed to assess the analgesic effects of sucralfate in people or animals with severe esophagitis, but anecdotal evidence indicates the drug's analgesic properties in people with esophagitis.…”

Section: Mechanism Of Action Biological Targets Efficacy Adverse Ementioning

confidence: 99%

ACVIM consensus statement: Support for rational administration of gastrointestinal protectants to dogs and cats

Marks

Kook

Papich

et al. 2018

Veterinary Internal Medicne

102

177

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The gastrointestinal (GI) mucosal barrier is continuously exposed to noxious toxins, reactive oxygen species, microbes, and drugs, leading to the development of inflammatory, erosive, and ultimately ulcerative lesions. This report offers a consensus opinion on the rational administration of GI protectants to dogs and cats, with an emphasis on proton pump inhibitors (PPIs), histamine type‐2 receptor antagonists (H2RAs), misoprostol, and sucralfate. These medications decrease gastric acidity or promote mucosal protective mechanisms, transforming the management of dyspepsia, peptic ulceration, and gastroesophageal reflux disease. In contrast to guidelines that have been established in people for the optimal treatment of gastroduodenal ulcers and gastroesophageal reflux disease, effective clinical dosages of antisecretory drugs have not been well established in the dog and cat to date. Similar to the situation in human medicine, practice of inappropriate prescription of acid suppressants is also commonplace in veterinary medicine. This report challenges the dogma and clinical practice of administering GI protectants for the routine management of gastritis, pancreatitis, hepatic disease, and renal disease in dogs and cats lacking additional risk factors for ulceration or concerns for GI bleeding. Judicious use of acid suppressants is warranted considering recent studies that have documented adverse effects of long‐term supplementation of PPIs in people and animals.

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Section: Mechanism Of Action Biological Targets Efficacy Adverse Ementioning

confidence: 99%

ACVIM consensus statement: Support for rational administration of gastrointestinal protectants to dogs and cats

Marks

Kook

Papich

et al. 2018

Veterinary Internal Medicne

102

177

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“…Proton pump inhibitors or H2 blockers can be used to decrease lower‐esophageal stricture pressure and reflux . Sucralfate may be started to decrease mucosal inflammation and promote healing . In this study, we found that at the onset of symptoms, all patients were prescribed oral analgesics and sucraflate.…”

Section: Discussionmentioning

confidence: 74%

Esophagitis associated with multimodality management of pediatric Ewing sarcoma of thorax

Agarwal¹,

Logie

Morris

et al. 2018

Pediatric Blood & Cancer

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Approximately one-third of patients with Ewing sarcoma of the thoracic region will develop acute esophagitis. An esophageal D5cm dose < 15 Gy and maximal esophageal dose < 47 Gy may keep the rate of acute esophagitis under 5%. However, the association with neutropenia and consistent response to antifungal therapy suggest chemotherapy-associated toxicity and an infectious component as part of the process.

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“…[6][7][8] Since stricture formation is a consequence of the inflammation and fibrosis that occurs during wound healing, medical treatment should focus on reducing the wound inflammation. [9] Although many agents, including retinoic acid, pentoxifylline, sucralfate, N-acetylcysteine, antibiotics, and steroids have been used in both clinical and experimental studies to prevent the development of strictures, only antibiotics and steroids have gained clinical application. [10][11][12][13] MB was first identified as an antimalarial agent by Ehrlich in 1981, and it has since been used in many different areas of clinical medicine including treatment of refractory distributive shock, renal stones, carbon monoxide poisoning, methemoglobinemia, and encephalopathy for years due to its low toxicity and wide availability.…”

Section: Introductionmentioning

confidence: 99%

“…[23] The current management protocol for corrosive esophagitis is still limited to antibiotics, steroids, and neutralization in the acute phase, although there are many other treatment methods that vary according to the phase and the severity of the damage. [9] To reduce inflammation and collagen synthesis and to prevent fibroplasia and stricture formation, numerous studies have been performed to evaluate the medical efficiency of antioxidant and anti-inflammatory agents such as sucralfate, palifermin, dimethyl sulfoxide, prednisolone, retinoic acid, zinc, trimetazidine, and pentoxifylline. [9][10][11][12][13]22,23] Despite the decreased stricture formation demonstrated in these studies, the rate of stricture formation is still 70-100% in high-grade corrosive esophagitis.…”

mentioning

confidence: 99%

“…[9] To reduce inflammation and collagen synthesis and to prevent fibroplasia and stricture formation, numerous studies have been performed to evaluate the medical efficiency of antioxidant and anti-inflammatory agents such as sucralfate, palifermin, dimethyl sulfoxide, prednisolone, retinoic acid, zinc, trimetazidine, and pentoxifylline. [9][10][11][12][13]22,23] Despite the decreased stricture formation demonstrated in these studies, the rate of stricture formation is still 70-100% in high-grade corrosive esophagitis. [9] MB, a nontoxic and safe dye, has both anti-adhesive and antiinflammatory properties.…”

mentioning

confidence: 99%

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The protective and anti-inflammatory effect of methylene blue in corrosive esophageal burns: An experimental study

Tanrıkulu

Kılınç

et al. 2018

Ulus Travma Acil Cerrahi Derg

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BACKGROUND: In developing countries, esophageal burns are quite common. They are caused by the ingestion of corrosive substances that may lead to esophageal perforation in the short-term and stricture formation in the long-term. Prevention of stricture progression in the esophagus is the main aim of the treatment for corrosive esophageal burns. We aimed to investigate the protective and anti-inflammatory effects of methylene blue (MB) treatment on corrosive esophageal burns. METHODS: Twenty-eight rats were used in the study and randomly divided into four equal groups; group 1 (Sham), group 2 (control), group 3 (topical treatment), and group 4 (topical plus systemic treatment). Except for group 1 (Sham group), all three groups received sodium hydroxide (NaOH) in order to generate esophageal burns. In addition, group 2 was given normal saline, group 3 topical MB, and group 4 topical and systemic MB. RESULTS: Hydroxyproline levels were found to be lower in each of the treatment groups as compared to the control group (p=0.005 for group 3 and p=0.009 for group 4). There were no differences in the tumor necrosis factor-α (TNF-α) levels between the groups. The stenosis index (SI) in the treatment groups was also lower than the control group (p=0.016 for group 3 and p=0.015 group 4). The histopathologic damage score (HDS) was prominently lower in group 4 as compared to the control group (p=0.05). CONCLUSION: MB is effective in treating tissue damage caused by corrosive esophageal burns and in preventing esophageal stenosis. Complication rates of corrosive esophageal burns may be decreased by using MB in the initial treatment stage.

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The efficiency of sucralfate in corrosive esophagitis: A randomized, prospective study

Cited by 25 publications

References 25 publications

ACVIM consensus statement: Support for rational administration of gastrointestinal protectants to dogs and cats

ACVIM consensus statement: Support for rational administration of gastrointestinal protectants to dogs and cats

Esophagitis associated with multimodality management of pediatric Ewing sarcoma of thorax

The protective and anti-inflammatory effect of methylene blue in corrosive esophageal burns: An experimental study

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