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Esophagitis in the presence of Barrett esophagus may be easily healed with PPI remedy; nevertheless, regression of Barrett epithelium, aside from small squamous islands, is never reported, even with excessive-dose PPI therapy . Recent ex vivo studies have advised that intermittent “pulses” of acid enhance Barrett epithelial cell proliferation, possibly increasing the risk of dysplasia and cancer. The clinical relevance of this data is supported by a 20-yr comply with-up study of 236 veteran sufferers by a single endoscopist.
Alternative methods of administering PPIs could also be needed in debilitated older sufferers who can’t swallow intact omeprazole or lansoprazole capsules. Both capsules can be opened and the granules taken with water, a HCO3 −-based mostly suspension, or apple or orange juice; alternatively, the granules can be sprinkled onto apple sauce or yogurt . There was concern in regards to the long-term safety of PPIs due to their profound acid suppression...
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