Efficacy of a proton pump inhibitor given in the early postoperative period to relieve symptoms of hiatal hernia after open heart surgery.

Abstract

PURPOSE:

To evaluate the efficacy of a proton pump inhibitor, we retrospectively reviewed patients who underwent gastric fiberscopy (GFS) in the early phase after cardiac surgery.

METHODS:

The subjects were 103 patients who underwent GFS for poor appetite, gastric pain, heartburn, or hematemesis after cardiac surgery. We divided the patients into two groups: group I consisted of 49 patients who received an H2-receptor antagonist (ranitidine hydrochloride 300 mg/day), and group II consisted of 54 patients who received a proton pump inhibitor (PPI; sodium rabeprazole 10 mg/day) as prophylactic treatment. The incidence of upper gastrointestinal (GI) disease was compared in the two groups.

RESULTS:

Gastric fiberscopy confirmed that 82.5% of the patients had type I hiatal hernia. The incidences of gastric pain and heartburn were significantly higher in group I (12.2% and 83.7%) than in group II (0% and 37.0%). Moreover, gastric bleeding occurred in two patients from group I, one [corrected] of whom died of coagulopathy. The incidences of hemorrhagic gastritis, active ulcer, and reflux esophagitis were significantly higher in group I than in group II, at 22.4%, 22.4%, and 24.5% vs 1.9%, 0%, and 7.4%.

CONCLUSIONS:

Early postcardiotomy GFS confirmed a high incidence of type I hiatal hernia. However, the proton pump inhibitor given in the early postoperative period proved more effective than the H2-receptor antagonist for relieving GI symptoms and preventing upper GI disorders after cardiac surgery.

• Authors: Mitsumasa Hata, Motomi Shiono, Hisakuni Sekino, Hidekazu Furukawa, Akira Sezai, Mitsuru Iida, Isamu Yoshitake, Tsutomu Hattori, Shinji Wakui, Makoto Taoka, Nanao Negishi, Yukiyasu Sezai
• Journal: Surgery today (Surg Today) Vol. 36 Issue 2 Pg. 131-4 ( 2006) ISSN: 0941-1291 [Print] Japan
• PMID: 16440158 (Publication Type: Comparative Study, Journal Article)

Chemical References

• 2-Pyridinylmethylsulfinylbenzimidazoles
• Benzimidazoles
• Proton Pump Inhibitors
• Rabeprazole
• Ranitidine
• Omeprazole

Topics

• 2-Pyridinylmethylsulfinylbenzimidazoles
• Adult
• Aged
• Aged, 80 and over
• Benzimidazoles (therapeutic use)
• Cardiac Surgical Procedures (adverse effects, methods)
• Dose-Response Relationship, Drug
• Drug Administration Schedule
• Female
• Gastroesophageal Reflux (diagnosis, drug therapy, etiology)
• Gastrointestinal Hemorrhage (etiology, prevention & control)
• Hernia, Hiatal (diagnosis, drug therapy, etiology)
• Humans
• Male
• Middle Aged
• Omeprazole (analogs & derivatives, therapeutic use)
• Patient Satisfaction
• Postoperative Care
• Probability
• Proton Pump Inhibitors
• Rabeprazole
• Ranitidine (therapeutic use)
• Risk Assessment
• Treatment Outcome