Long-term treatment of gastro-oesophageal reflux disease with omeprazole.

Reflux oesophagitis is a chronic disorder with frequent relapses on cessation of initial successful treatment. In patients with reflux oesophagitis, treatment with the acid pump inhibitor, omeprazole, has repeatedly been demonstrated to prevent the recurrence of symptoms and of erosive and/or ulcerative lesions in the oesophagus. Comparative trials have shown that an average of 82% of oesophagitis patients were maintained in endoscopic and symptomatic remission over a period of 12 months when treated with omeprazole, 20 mg once daily. This compares with only 36% of patients in remission when given 'full-dose' H2-receptor antagonist therapy (ranitidine, 300 mg daily). It is interesting to note that, in a recent trial, 62% of reflux oesophagitis patients were in remission after 12 months of treatment with omeprazole, 10 mg once daily, compared with the corresponding figure of 72% among those on 20 mg once daily. In patients poorly responsive to control of oesophagitis with H2-receptor antagonists, omeprazole at a dose of at least 20 mg daily is required to achieve symptom resolution and endoscopic healing--and remission can be maintained for years with continued omeprazole treatment. Omeprazole has been shown to have a good long-term safety profile, as evaluated in these trials.