P-196RABEPRAZOLE PROTECTS REFLUX OESOPHAGITIS AFTER TOTAL GASTRECTOMY IN RAT MODEL

• Published in: Interactive cardiovascular and thoracic surgery 2014-06, Vol.18 (suppl_1), p.S51-S52
• Main Author: Naoki, Hashimoto
• Format: Article
• Language: English
• ISSN: 1569-9293; 1569-9285
• DOI: 10.1093/icvts/ivu167.196

Objectives: Reflux of duodenal content into the oesophagus has a role in the pathogenesis of oesophageal inflammatory lesions. As little is known about effective therapy, we studied the effect of proton pump inhibitor (PPI) therapy on oesophageal bile reflux in oesophagitis after total gastrectomy. The purpose of this study is to clarify the effect of PPI (Rabeparazole) on reflux oesophagitis. Methods: Sixteen 8-week old male Wistar rats underwent total gastrectomy and oesophagoduodenostomy to induce oesophageal reflux of biliary and pancreatic juice. In 5 rats the sham operation (Sham) was performed. One week following surgery, they were treated with saline (Control) (n = 8) PPI (Rabeprazole) (n = 8) (30 mg/kg/day) ip for 2 weeks. Three weeks after the operation, all rats were killed and the oesophagus was evaluated histologically. Oesophageal injury was evaluated by macroscopic, microscopic findings, and expression of COX2 and PGE2. Oesophageal washing was aspirated for the evaluation of bile acid activity. Results: Three weeks after surgery, duodenal reflux induced oesophageal erosions and ulcer formation as well as a marked thickening of the oesophageal wall. Histological study showed an increase of thickness of the oesophageal mucosa, hyperplasia of epidermis and basal cells, and ulcer formation. The macroscopic ulcer score and microscopic ulcer length were significantly reduced by treatment with Rabeprazole. The enhanced expression of COX2 and PGE2 in the control group was also markedly inhibited in the Rabeprazole treated group. The bile acid activity in the oesophageal lumen was significantly increased in the control group, and this increase was significantly inhibited in the Rabeprazole treated group. Conclusions: We have demonstrated that Rabeprazole is an effective therapy for reflux oesophagitis after total gastrectomy due to bile reflux. These results indicate that bile acid, which is inhibited by Rabeprazole, plays an important role in the mucosal damage induced by duodenal reflux and that it can be a therapeutic target in patients with reflux oesophagitis. Disclosure: No significant relationships.