Clinical Endoscopy

  • 제56권2호
  • /
  • Pages.194-202
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  • 2023
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  • 2234-2400(pISSN)
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  • 2234-2443(eISSN)
대한소화기내시경학회 (The Korean Society of Gastrointestinal Endoscopy)
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Bile acid sequestrants in poor healing after endoscopic therapy of Barrett's esophagus

  • Lukas Welsch (Department of Gastroenterology and Hepatology, Hospital of the Johann Wolfgang Goethe University Frankfurt) ;
  • Andrea May (Department of Gastroenterology, Oncology and Pneumology, Asklepios Paulinen Klinik) ;
  • Tobias Blasberg (Department of Gastroenterology, Gastrointestinal Oncology and Interventional Endoscopy, Sana Klinikum Offenbach) ;
  • Jens Wetzka (Department of Gastroenterology, Oncology and Pneumology, Asklepios Paulinen Klinik) ;
  • Elisa Muller (Department of Gastroenterology and Hepatology, Hospital of the Johann Wolfgang Goethe University Frankfurt) ;
  • Myriam Heilani (Department of Gastroenterology and Hepatology, Hospital of the Johann Wolfgang Goethe University Frankfurt) ;
  • Mireen Friedrich-Rust (Department of Gastroenterology and Hepatology, Hospital of the Johann Wolfgang Goethe University Frankfurt) ;
  • Mate Knabe (Department of Gastroenterology and Hepatology, Hospital of the Johann Wolfgang Goethe University Frankfurt)
  • 투고 : 2022.04.08
  • 심사 : 2022.06.13
  • 발행 : 2023.03.30
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초록

Background/Aims: Endoscopic therapy for neoplastic Barrett's esophagus (BE) has become the standard of care over the past two decades. In clinical practice, we regularly encounter patients who fail to achieve complete squamous epithelialization of the esophagus. Although the therapeutic strategies in the individual stages of BE, dysplasia, and esophageal adenocarcinoma are well studied and largely standardized, the problem of inadequate healing after endoscopic therapy is only marginally considered. This study aimed to shed light on the variables influencing inadequate wound healing after endoscopic therapy and the effect of bile acid sequestrants (BAS) on healing. Methods: Retrospective analysis of endoscopically treated neoplastic BE in a single referral center. Results: In 12.1% out of 627 patients, insufficient healing was present 8 to 12 weeks after previous endoscopic therapy. The average follow-up duration was 38.8±18.4 months. Complete healing was achieved in 13 patients already after intensifying proton pump inhibitor therapy. Out of 48 patients under BAS, 29 patients (60.4%) showed complete healing. An additional eight patients (16.7%) improved, but only partial healing was achieved. Eleven (22.9%) patients showed no response to BAS augmented therapy. Conclusions: In cases of insufficient healing even under exhaustion of proton pump inhibitors, treatment with BAS can be an option as an ultimate healing attempt.

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참고문헌

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