ABSTRACT
BACKGROUND/OBJECTIVES: Only a few papers have treated of the relationship between Barrett's esophagus (BE) or erosive esophagitis (E) and coffee or tea intake. We evaluated the role of these beverages in BE and E occurrence. SUBJECTS/METHODS: Patients with BE (339), E (462) and controls (619) were recruited. Data on coffee and tea and other individual characteristics were collected using a structured questionnaire. RESULTS: BE risk was higher in former coffee drinkers, irrespective of levels of exposure (cup per day; ⩽1: OR=3.76, 95% CI 1.33-10.6; >1: OR=3.79, 95% CI 1.31-11.0; test for linear trend (TLT) P=0.006) and was higher with duration (>30 years: OR=4.18, 95% CI 1.43-12.3; TLT P=0.004) and for late quitters, respectively (⩽3 years from cessation: OR=5.95, 95% CI 2.19-16.2; TLT P<0.001). The risk of BE was also higher in subjects who started drinking coffee later (age >18 years: OR=6.10, 95% CI 2.15-17.3). No association was found in current drinkers, but for an increased risk of E in light drinkers (<1 cup per day OR =1.85, 95% CI 1.00-3.43).A discernible risk reduction of E (about 20%, not significant) and BE (about 30%, P<0.05) was observed in tea drinkers. CONCLUSIONS: Our data were suggestive of a reduced risk of BE and E with tea intake. An adverse effect of coffee was found among BE patients who had stopped drinking coffee. Coffee or tea intakes could be indicative of other lifestyle habits with protective or adverse impact on esophageal mucosa.
Subject(s)
Barrett Esophagus/prevention & control , Coffee , Esophagitis/prevention & control , Functional Food , Tea , Adult , Aged , Barrett Esophagus/diagnostic imaging , Barrett Esophagus/epidemiology , Barrett Esophagus/etiology , Case-Control Studies , Coffee/adverse effects , Endoscopy, Gastrointestinal , Esophageal Mucosa/diagnostic imaging , Esophagitis/diagnostic imaging , Esophagitis/epidemiology , Esophagitis/etiology , Female , Humans , Incidence , Italy/epidemiology , Male , Middle Aged , Risk Factors , Self Report , Tea/adverse effects , Teas, Herbal/adverse effectsABSTRACT
OBJECTIVE: For the long term maintenance treatment of reflux esophagitis several strategies have been proposed with the aim of reducing the daily dosage or the frequency of drug administration. However, the available clinical studies are scarce and are often not controlled or conducted on a reduced number of cases. We aimed to compare the efficacy of two doses of lansoprazole (15 mg once daily and 30 mg on alternate days) in maintaining endoscopic healing and symptom relief over a 6-month period. METHODS: One hundred thirty-seven patients with Savary-Miller grades I-III reflux esophagitis healed after an 8-wk treatment with lansoprazole (30 mg daily) were divided into two main groups for a 6-month maintenance therapy period: lansoprazole, 15 mg once daily (group 15qd) and lansoprazole, 30 mg on alternate days (group 30qod). These two main groups were further subdivided according to the time of drug administration; morning (15qdm and 30qodm) and evening (15qde and 30qode). Each patient underwent esophagogastroduodenoscopy before entry into the study, after 8 wk of acute therapy, and after 6 months of maintenance therapy; 24-h esophageal-gastric pH monitoring was performed at baseline and during the last week of maintenance therapy. RESULTS: At the end of the maintenance period the recurrence of esophagitis was observed in 12.1% of group 15qd patients and in 19.0% of group 30qod patients, without significant differences between the two groups. The frequency of patients without reflux symptoms after the 6-month period was the same for both groups; however, a significant increase of heartburn was observed in group 30qod patients (from 12.1% to 28.6%, p = 0.007). The time of drug administration (morning and evening) had no influence on the outcome of treatment. Both regimens significantly reduced esophageal acid exposure time and increased the median 24-h gastric pH. CONCLUSIONS: Both long term lansoprazole regimens are equally effective in preventing the recurrence of esophagitis, independent of the modality of drug administration. The daily administration seems to have a better effect on the prevention of symptom recurrence.
Subject(s)
Enzyme Inhibitors/administration & dosage , Esophagitis, Peptic/drug therapy , Omeprazole/analogs & derivatives , Omeprazole/administration & dosage , 2-Pyridinylmethylsulfinylbenzimidazoles , Adult , Dose-Response Relationship, Drug , Double-Blind Method , Drug Administration Schedule , Enzyme Inhibitors/adverse effects , Enzyme Inhibitors/therapeutic use , Esophagitis, Peptic/metabolism , Esophagitis, Peptic/pathology , Esophagoscopy , Female , Gastric Acid/metabolism , Helicobacter pylori/isolation & purification , Humans , Lansoprazole , Male , Middle Aged , Omeprazole/adverse effects , Omeprazole/therapeutic use , Secondary Prevention , Stomach/microbiology , Treatment OutcomeABSTRACT
The AA. point out the meaning of the urinary estriol dosage in high risk pregnancy. The screening must be frequent and regular, with constant growing curve all time along. A sudden fall down of the rate shows a severe malaise of the phoetus and proper therapy is badly needed. Extemporary screenings dont supply any sufficient knowledge.
