Sucralfate has been evaluated in
reflux esophagitis, based on its protective adherence to denuded surfaces, its
bile salt-binding properties, and its cytoprotective properties.
Histamine (H2)-receptor blockers are currently considered the standard
therapy. The goal of this study was to compare the potential efficacy of
sucralfate with that of
cimetidine. A single-blind, randomized, multicenter study was performed in 42 patients with endoscopically documented
reflux esophagitis. Patients were randomly given 1 g of
sucralfate suspension four times daily or 400 mg of
cimetidine four times daily for eight weeks. Forty patients were evaluated after eight weeks. Symptomatic improvement was good and comparable in both groups. In two patients given
sucralfate and one given
cimetidine, side effects were noted but did not necessitate withdrawal from the study. Endoscopy showed improvement in 53 percent of patients and healing of
esophagitis in 31 percent after
sucralfate treatment. With
cimetidine, improvement was seen in 67 percent and healing occurred in 14 percent. In one patient receiving
cimetidine, distal
esophageal stenosis developed, requiring dilatation
therapy. It is concluded that treatment with
sucralfate improves the symptomatology and severity of
reflux esophagitis. The results obtained with
sucralfate appear comparable to those with
cimetidine.
Sucralfate may therefore be considered as a valid alternative to H2-receptor antagonist
therapy in treating
reflux esophagitis.