Endoscopic study of upper gastrointestinal changes during steroids therapy and the effect of a cytoprotective drug

ABSTRACT

The present study included 25 patients [15 males and 10 females] with various disorders. They were under systemic treatment with corticosteroids for at least 8 weeks. The upper GIT was examined endoscopically to study the effect of prolonged use of corticosteroids. Patients that showed ulcer and/or erosions stopped corticosteroids and received a cytoprotective agent [sucralfate] for 3-4 weeks and re-examined endoscopically. Serum cortisol level was estimated to all the patients and was repeated for those patients with GIT lesions after the stoppage of corticosteroids and the intake of sucralfate. The study showed that 12 patients had ulcers and/or erosions while the rest of the patients [13 patients] had no such lesions. On endoscopic re-examination, it was found that lesions were completely healed after the stoppage of corticosteroids and the intake of sucralfate. Serum cortisol was subnormal in 23 patients due to the inhibitory influence of corticosteroids on the hypothalamic pituitary axis. On stoppage of corticosteroids, the serum cortisol level was significantly elevated. The study also revealed that the effect of corticosteroids on GIT does not depend totally on the dosage and the duration or the route of administeration. The effect of corticosteroids depends to some extent on personal susptibility