Proton-pump inhibitor therapy and the development of dysplasia in patients with Barrett’s oesophagus

摘要: Objective To examine whether proton-pump inhibitor (PPI) therapy influences the incidence and progression of dysplasia in patients with Barrett's oesophagus. Design setting Review prospective data on undergoing surveillance regular endoscopy biopsy at a private centre Canberra, ACT, between 1981 2001. Patients 350 diagnosed Interventions PPI was progressively introduced into clinical practice from late 1989. Once begun, ongoing, no attempt to reduce dose. Main outcome measures Relationship development or adenocarcinoma delay diagnosis oesophagus starting determined by Cox regression analyses, stratified year enrollment. Age, sex, presence macroscopic markers (severe oesophagitis, nodularity, ulcer, stricture) use aspirin non-steroidal anti-inflammatory drugs were considered as confounding factors analyses. Results The had 1422 endoscopies, median follow-up 4.7 years. who delayed using for 2 years more after 5.6 times (95% CI, 2.0-15.7) risk developing low-grade any given time those used first year. Similar results found high-grade (hazard ratio, 20.9; 95% 2.8-158). Conclusions Use ongoing appeared beneficial prevention We suggest that all this condition, even oesophagitis symptoms, should be encouraged continue long term therapy.