s-1743 and Abdominal-Pain

Here we aimed to evaluate the effectiveness of esomeprazole treatment strategies comparing with other proton pump inhibitors (PPI) in clinical practice for six months in the management of patients with symptomatic gastroesophageal reflux disease (GERD). An extensive search of the literature focusing on PPI therapeutic evaluation was performed up to December 2014. Risk ratio (RR) with its corresponding 95% confidence intervals (CIs) in each study was chosen as the effect size. Cochrane's Q statistic and I2 test were both conducted to evaluate heterogeneity across individual studies. Meta-regression was conducted to explore the source of heterogeneity and sensitive analysis was performed to assess the risk bias for the meta-analysis. Totally, eleven trials with high quality enrolled in the meta-analysis. Esomeprazole therapy (20 mg daily) had lower relapse rates than other drugs during six months maintenance treatment (RR = 0.67; 95% CI: 0.55-0.83). Heartburn (RR = 0.72; 95% CI: 0.57-0.92) and epigastric pain (RR = 0.82, 95% Cl: 0.70-0.96) were less likely to happen after esomeprazole treatment, and no significant advantage was found on acid regurgitation and dysphagia. Moreover, lower risk for serious adverse events was observed after esomeprazole therapy (RR = 1.40, 95% CI: 1.04-1.88). Blind method or difference controlled drugs did not influence heterogeneity across studies. Moreover, the conclusion on acid regurgitation, abdominal pain and dysphagia might be unstable. In GERD patients, esomeprazole 20 mg daily is more effective than other PPIs regarding relapse rates, symptoms of epigastric pain and heartburn, and serious adverse events.

Topics: Abdominal Pain; Deglutition Disorders; Esomeprazole; Gastroesophageal Reflux; Humans; Proton Pump Inhibitors; Recurrence; Regression Analysis

Gastroscopy and gastroscopic mucosal biopsy techniques have become increasingly used as of late for evaluating symptoms presumed to be originated in the upper gastrointestinal tract. Patients often complain however of abdominal pain post-gastroscopic mucosal biopsy, and this study aimed to explore the necessity of acid inhibitors when abdominal pain worsened.. In this randomized, double-blinded, placebo-controlled study, we screened 272 participants, and ultimately enrolled 200 into the study. These 200 participants were randomly assigned in a 1:1 ratio to receive acid inhibitors (esomeprazole, treatment group, n=100; dose,20 mg/d) or matched placebo (control group, n=100) for 3 days post-gastroscopic mucosal biopsy. The presence of abdominal pain was observed pre-and post-gastroscopy, and the therapeutic effect of esomeprazole was assessed. This study was registered at the Chinese clinical trial registry as ChiCTR-TRC-00000500.. Ten subjects were lost to followup (4 in treatment group; 6 in the control group). There was no significant difference in the number of subjects with aggravating abdominal pain (treatment 29.2% vs. control 22.3%; p>0.05) between the two groups. Esomeprazole did not significantly (p>0.05) affect the rate of abdominal pain within 24 h (treatment 27.1% vs. control 19.1%), 48 h (treatment 40.6% vs. control 27.7%), and 96 h (treatment 43.8% vs. control 34.0%) on abdominal pain in all in the evaluated subjects. Between the two groups however, a statistically significant difference (p<0.05) was found on overall effective treatment rates at 48 h (treatment 92.9% vs. control 66.7%) and at 96 h (treatment 100% vs. control 81%) in the subjects with worsened abdominal pain.. The study suggests that routine prophylaxis with acid inhibitors is not recommended for all patients post-gastroscopic mucosal biopsy, however acid inhibitors should be administered for patients with aggravating abdominal pain.

Topics: Abdominal Pain; Adult; Biopsy; Double-Blind Method; Esomeprazole; Female; Gastric Mucosa; Gastroscopy; Humans; Male; Pain Measurement; Proton Pump Inhibitors; Young Adult

The primary objective was to assess the safety of esomeprazole 20 or 40 mg once daily in adolescents with clinically diagnosed gastroesophageal reflux disease (GERD). A secondary aim was to assess changes in GERD symptoms after esomeprazole therapy.. In this multicenter, randomized, double-blind study, adolescents ages 12 to 17 years inclusive received esomeprazole 20 or 40 mg once daily for 8 weeks. Adverse events and changes in clinical parameters (eg, physical examination, laboratory measurements) were evaluated to assess safety. Patients or their parents or guardians scored symptom severity daily, and investigators scored overall GERD symptom severity every 2 weeks using a 4-point scale.. In the 148 adolescents with safety data, treatment-related and non-treatment-related adverse events were reported by 75% and 78% of patients in the esomeprazole 20- and 40-mg groups, respectively. Twenty-two patients (14.9%) experienced adverse events that were considered related to treatment; the most common were headache (8%, 12/148), abdominal pain (3%, 4/148), nausea (2%, 3/148), and diarrhea (2%, 3/148). No serious adverse events or clinically important findings in other safety assessments were observed. At baseline, 68% (100/147) had heartburn, 63% (93/147) had epigastric pain, 57% (84/147) had acid regurgitation, and 15% (22/147) had vomiting symptoms. Symptom scores decreased significantly in both the esomeprazole 20-mg and 40-mg groups by the final study week (P < 0.0001). Investigators rated 63.1% (94/149) of the patients as having moderate or severe symptoms at baseline; at the final visit, this percentage decreased significantly to 9.3% (13/140; P < .0001).. In adolescent patients with GERD, esomeprazole 20 or 40 mg daily for 8 weeks was well tolerated, and GERD-related symptoms were significantly reduced from baseline values in both groups.

Topics: Abdominal Pain; Adolescent; Anti-Ulcer Agents; Child; Diarrhea; Dose-Response Relationship, Drug; Double-Blind Method; Esomeprazole; Female; Gastroesophageal Reflux; Headache; Heartburn; Humans; Male; Nausea; Severity of Illness Index; Treatment Outcome; Vomiting

Topics: Abdominal Pain; Adult; Amoxicillin-Potassium Clavulanate Combination; Biopsy, Needle; Esomeprazole; Female; Fever; Gastritis; Gastroscopy; Humans; Immunohistochemistry; Infusions, Intravenous; Prognosis; Rare Diseases; Severity of Illness Index; Streptococcal Infections; Tomography, X-Ray Computed; Treatment Outcome; Vomiting