Esophagus healing

The PPIs are superior to H2RAs in patients with moderate to severe GERD. This includes not only patients with erosive esophagitis or complicated symptoms (Barrett s esophagus or strictures), but also those with non-erosive reflux disease who have moderate to severe symptoms. Symptomatic relief is seen in approximately 83% of patients and healing rates at 8 weeks as judged by endoscopy are 78%.1... 

Proton pump inhibitors are the most effective agents for the treatment of nonerosive and erosive reflux disease, esophageal complications of reflux disease (peptic stricture or Barrett s esophagus), and extraesophageal manifestations of reflux disease. Once-daily dosing provides effective symptom relief and tissue healing in 85-90% of patients up to 15% of patients require twice-daily dosing. 

The proton pump (H+K+ATPase) of the apical membrane of the parietal cells is the ultimate mechanism that governs acid secretion. Among a family of benzimidazole derivatives, omeprazole (Losec) promotes the healing of ulcers in the stomach, duodenum, and esophagus, and is of special value in patients who do not respond to H2-receptor antagonists. 

After ingestion, corrosive injury to the esophagus and stomach are commonly found. With skin contact, the symptoms are severe pain and brownish or yellow stains. Burns usually penetrate the full thickness of the skin, have sharply defined edges, and heal slowly with scar formation. With eye contact, conjunctival edema and corneal destruction is prevalent. Symptoms include pain, tearing, and photophobia. 

An emergency operation was performed and consisted of esophagostomy, gastrostomy, and stripping of the esophagus. Three weeks after admission, we performed excision of necrotic tissue (Fig. 4.97) and mesh-autograft transplantation, and the wound healed adequately within 8 days (Fig. 4.98). At this time (3 weeks after admission) the facial lesions are completely healed (Fig. 4.99). 

---