Omeprazole for hiatal hernia: Omeprazole for Hiatal Hernia Reviews

19.01.202224.07.2023 by alexxlab

Omeprazole for Hiatal Hernia Reviews

Save

Brand names:
Prilosec,
Prilosec OTC,
Omesec

Omeprazole
has an average rating of 3.2 out of 10 from a total of 19 reviews
for the
off-label treatment of Hiatal Hernia.
16% of reviewers reported a positive experience, while 74% reported a negative experience.

Filter by condition
All conditionsBarrett’s Esophagus (17)Duodenal Ulcer (8)Erosive Esophagitis (13)Gastritis/Duodenitis (43)GERD (274)Helicobacter Pylori Infection (9)Hiatal Hernia (19)Indigestion (48)Laryngopharyngeal Reflux (9)Multiple Endocrine Adenomas (1)Stomach Ulcer (28)Systemic MastocytosisZollinger-Ellison Syndrome (1)

Omeprazole rating summary

3.2/10 average rating

19 ratings from 19 user reviews.

Compare all 5 medications used in the treatment of Hiatal Hernia.

10		5%
9		11%
8		0%
7		0%
6		5%
5		5%
4		0%
3		16%
2		11%
1		47%

Reviews for Omeprazole

Frequently asked questions

What foods should I avoid when taking omeprazole?
How soon after taking levothyroxine can I take omeprazole?
Is famotidine safer than omeprazole for heartburn?
Pantoprazole vs. omeprazole: What’s the difference between them?

Are you taking this medicine?

Add your review
Learn more about Omeprazole

More FAQ

Nexium vs Prilosec: What’s the difference between them?
Can I take omeprazole in the morning and famotidine at night?
Can you take an antacid with omeprazole?
When’s the best time to take omeprazole: before or after a meal?

Reviews may be edited to correct grammar/spelling or to remove inappropriate language and content. Reviews that appear to be created by parties with a vested interest are not published. This information is not intended to endorse any particular medication. While these reviews may be helpful, they are not a substitute for the expertise, knowledge, and judgement of healthcare professionals.

Learn more about Hiatal Hernia

Care guides

Hiatal Hernia

Symptoms and treatments

Hiatal Hernia

More about omeprazole

Check interactions
Compare alternatives
Pricing & coupons
Reviews (476)
Drug images
Side effects
Dosage information
Patient tips
During pregnancy
Support group
Drug class: proton pump inhibitors
Breastfeeding

Patient resources

Drug Information
Omeprazole Delayed-Release Capsules and Tablets (OTC)
Omeprazole Orally-Disintegrating Tablets
Omeprazole Delayed-Release Capsules
Omeprazole Powder for Oral Suspension

Other brands

Prilosec, Prilosec OTC

Professional resources

Prescribing Information

Related treatment guides

Barrett’s Esophagus
Duodenal Ulcer
Erosive Esophagitis
GERD

Hiatal hernia is the key factor determining the lansoprazole dosage required for effective intra-oesophageal acid suppression

Clinical Trial

. 2002 May;16(5):881-6.

doi: 10.1046/j.1365-2036.2002.01248.x.

M Frazzoni¹, E De Micheli, A Grisendi, V Savarino

Affiliations

Affiliation

¹ Divisione di Medicina Interna e Gastroenterologia, Ospedale S. Agostino, Modena, Italy. [email protected]

PMID:
11966495
DOI:
10.1046/j.1365-2036.2002.01248.x

Free article

Clinical Trial

M Frazzoni et al.

Aliment Pharmacol Ther.

2002 May.

Free article

. 2002 May;16(5):881-6.

doi: 10.1046/j.1365-2036.2002.01248.x.

Authors

M Frazzoni¹, E De Micheli, A Grisendi, V Savarino

Affiliation

¹ Divisione di Medicina Interna e Gastroenterologia, Ospedale S. Agostino, Modena, Italy. [email protected]

PMID:
11966495
DOI:
10.1046/j.1365-2036.2002.01248.x

Abstract

Background:

Effective intra-oesophageal acid suppression can be achieved with lansoprazole. The daily dosage could be influenced by the presence of hiatal hernia.

Aim:

To assess the lansoprazole daily dosage required to normalize oesophageal acid exposure in patients with and without hiatal hernia.

Methods:

Fifty patients with complications or atypical manifestations of gastro-oesophageal reflux disease were given lansoprazole, 30 mg once daily. Three to four weeks after the start of treatment, patients underwent oesophageal pH monitoring while on therapy. If the results were still abnormal, the lansoprazole dosage was doubled and 24-h pH-metry was repeated 20-30 days thereafter.

Results:

A 30-mg daily dosage of lansoprazole normalized oesophageal acid exposure in 70% of cases, whilst a 60-mg daily dosage was necessary in the remainder: the two groups differed only in the presence of hiatal hernia (28% vs. 100%, respectively; P=0.000). Effective intra-oesophageal acid suppression was obtained in all 25 patients without hiatal hernia with the 30-mg daily dosage of lansoprazole.

Conclusions:

Hiatal hernia is the key factor determining the lansoprazole dosage required for effective intra-oesophageal acid suppression in complicated and atypical gastro-oesophageal reflux disease. High efficacy of a 30-mg daily dosage of lansoprazole can be predicted in the absence of hiatal hernia.

Cited by

A Population Pharmacokinetic Model of Vonoprazan: Evaluating the Effects of Race, Disease Status, and Other Covariates on Exposure.
Scarpignato C, Leifke E, Smith N, Mulford DJ, Lahu G, Facius A, Howden CW.
Scarpignato C, et al.
J Clin Pharmacol. 2022 Jun;62(6):801-811. doi: 10.1002/jcph.2019. Epub 2022 Feb 8.
J Clin Pharmacol. 2022.
PMID: 34935142
Free PMC article.
High-resolution manometry is superior to endoscopy and radiology in assessing and grading sliding hiatal hernia: A comparison with surgical in vivo evaluation.
Tolone S, Savarino E, Zaninotto G, Gyawali CP, Frazzoni M, de Bortoli N, Frazzoni L, Del Genio G, Bodini G, Furnari M, Savarino V, Docimo L.
Tolone S, et al.
United European Gastroenterol J. 2018 Aug;6(7):981-989. doi: 10.1177/2050640618769160. Epub 2018 Apr 20.
United European Gastroenterol J. 2018.
PMID: 30228885
Free PMC article.
Esophagogastric Junction Morphology and Distal Esophageal Acid Exposure.
Akimoto S, Singhal S, Masuda T, Yamamoto SR, Svetanoff WJ, Mittal SK.
Akimoto S, et al.
Dig Dis Sci. 2016 Dec;61(12):3537-3544. doi: 10.1007/s10620-016-4331-y. Epub 2016 Oct 11.
Dig Dis Sci. 2016.
PMID: 27730315
Combination of angiotensin II receptor blockers promotes proton pump inhibitor-based healing of reflux esophagitis.
Miwa H, Hongo M, Kusano M; J-FAST Group.
Miwa H, et al.
J Gastroenterol. 2012 Mar;47(3):249-55. doi: 10.1007/s00535-011-0479-6. Epub 2011 Nov 1.
J Gastroenterol. 2012.
PMID: 22041918
Clinical Trial.
Impedance-pH reflux patterns can differentiate non-erosive reflux disease from functional heartburn patients.
Savarino E, Zentilin P, Tutuian R, Pohl D, Gemignani L, Malesci A, Savarino V.
Savarino E, et al.
J Gastroenterol. 2012 Feb;47(2):159-68. doi: 10.1007/s00535-011-0480-0. Epub 2011 Oct 25.
J Gastroenterol. 2012.
PMID: 22038553

See all “Cited by” articles

Publication types

MeSH terms

Substances

Gastroesophageal reflux disease (GERD). Hernia of the esophageal opening of the diaphragm (HH). | Center for Endosurgical Technologies

Gastroesophageal reflux disease (GERD) is a disease characterized by the reflux of gastric contents into the esophagus.

Hiatal hernia is an enlargement of the hiatus that allows part of the stomach to enter the chest. In 90% hiatal hernia leads to GERD.

40% of people constantly (with varying frequency) experience heartburn, the main symptom of GERD. In general, the prevalence of GERD in Russia among the adult population is 40-60%, and esophagitis is found in 45-80% of people with GERD.

Causes of GERD.

The human stomach contains hydrochloric acid, the walls of the stomach are resistant to acid. The esophagus does not have such stability. The body has a number of mechanisms that prevent the entry of gastric contents into the esophagus. For various reasons, these mechanisms may not be able to cope, and gastric contents enter the esophagus, burning its walls.

D The main symptom of GERD is heartburn,

occurs in 83% of patients. In addition, symptoms of reflux (casting) can be pain in the upper abdomen and behind the sternum, belching, regurgitation of food, and swallowing disorders. GERD can also lead to disruption of the heart and lungs. Symptoms may be aggravated by violation, alcohol intake, physical activity, bending over and in a horizontal position.

Diagnosis of GERD is based on characteristic complaints. The main method of instrumental diagnosis of GERD is FGS. If necessary, X-ray examination with contrast is performed.

Treatment of GERD must be prescribed by a doctor.

This usually includes diet and proton pump inhibitors (omeprazole, pariet). The main treatment should be carried out within 4-8 weeks, maintenance therapy – 6-12 months. In this case, the probability of relapse (return of the disease) is up to 80% with erosive esophagitis and up to 98% with improperly prescribed treatment.

In addition, it is necessary: 

Reduce body weight (if it is increased), stop smoking;
Diet: Avoid tomatoes in any form, acidic fruit juices, gas-producing foods, fats, chocolate, coffee, garlic, onions, peppers, alcohol, very spicy, hot or cold foods, and carbonated drinks;
Overeating should be avoided; they should stop eating two hours before bedtime. You should not increase the number of meals: it is necessary to observe 3-4 meals a day without snacks;
Conditions that increase intra-abdominal pressure should be prevented (exclusion of loads that increase intra-abdominal pressure, wearing corsets, bandages and tight belts, lifting weights of more than 8-10 kg on both hands, work associated with forward bending of the torso, physical exercises associated with overstrain of the abdominal muscles)

In some cases, an operation is prescribed.

Surgery is necessary if:

Therapy fails for 3 months or more (reflux persists or pain or heartburn persists)
Presence of heart attacks (angina pectoris, arrhythmias) caused by GERD
Organic damage to the esophagus (scarring, stenosis)
Barrett’s esophagus according to FGS

CAUTION. Barrett’s esophagus is one possible complication of GERD. Barrett’s esophagus is 125 times more likely to develop esophageal cancer than the general population!!! Esophageal cancer is very aggressive and responsive to therapy.

Laparoscopic fundoplication is the gold standard for GERD surgery worldwide.

In this operation, the fundus of the stomach is wrapped around the esophagus and sutured. The created cuff prevents the reflux of gastric contents into the esophagus.

We have been performing fundoplication since 2001. During this time, more than 300 operations have been performed. In 15 years, we have never needed to switch to open surgery. The presence of previous operations is not a contraindication to surgery.

The operation is very well tolerated by the patient. After our operations, the patient stays in the hospital for 1 day (on average). Most patients are discharged the next day. Pain is minimal.

We perform the operation with a laparoscopic (endovideosurgical) approach. With this technique, there is no large incision. 5 punctures of the anterior abdominal wall are performed (5 and 10 mm each). An inert gas is pumped inside, a video camera and instruments are introduced. The operation is carried out from the inside.

After the operation, you must follow a diet and limit physical activity for a month. A month later, the restrictions are lifted.

To make an appointment for a consultation: e-mail: [email protected], tel.: +7 (391) 297-52-52

5

In the 1980s and 1990s, the number of patients requiring surgical treatment significantly decreased. This was due to the emergence of new antisecretory, antacid and prokinetic drugs. Over the past decade, the developed drug treatment regimens have significantly reduced the risk of complications and improved the quality of life of patients with mild to moderate reflux esophagitis. However, the main problem of conservative treatment was and remains an almost complete relapse of the disease after the termination of the next course of drug therapy. The untimely performance of the operation for reflux esophagitis and HH is largely due to the fact that surgeons and gastroenterologists still do not have a unified point of view on the tactics of treating patients with these pathological conditions. Disputes continue about the indications for its surgical treatment and the timeliness of the transition from conservative to surgical treatment. Particularly controversial are the issues of choosing treatment tactics for mild and moderate reflux esophagitis.

It is undesirable to take drugs that reduce the tone of the LES (theophylline, progesterone, antidepressants, nitrates, prostaglandins, calcium antagonists, β-blockers, anticholinergic drugs), as well as having an adverse effect on the mucosa of the esophagus (non-steroidal anti-inflammatory drugs, doxycycline, quinidine).

Drug treatment should be aimed at reducing the acidity of gastric juice, neutralizing the produced hydrochloric acid and accelerating the evacuation of food from the stomach. To this end, therapy may include the use of various groups of drugs.

Antacids (almagel, maalox, phosphalugel, gastal, etc.) and alginates (gaviscon, topalkan, etc.) are superior to other drugs in terms of the speed of achieving a therapeutic effect (pain and heartburn relief). Antacids are prescribed for symptomatic purposes, their action is aimed at neutralizing the acid and, unfortunately, for a short time. Their main active ingredients are aluminum hydroxide, magnesium trisilicate, bismuth nitrate. Some of the above complex antacids are available in tablets, others – in the form of a gel. The frequency of their intake is determined by the severity of clinical symptoms, usually 4-5 times a day between meals and at bedtime. The advantage of these drugs is good tolerability by most patients and the rapid onset of the clinical effect.

There are, however, adverse effects of taking antacid preparations. In particular, aluminum-containing drugs with prolonged use can cause hypophosphatemia and constipation. After a series of chemical transformations, these preparations form poorly soluble compounds excreted with feces in the human intestine, which include phosphorus. This can be avoided by the appointment of phosphorus-containing agents (for example, phosphalugel, but its alkalizing ability is less than that of almagel).

Massive therapy with calcium carbonate leads to alkalosis and is contraindicated in hypercalcemia, osteochondrosis, the presence of calcium-containing stones in the kidneys and gallbladder.

Taking into account the important role of esophageal and gastric motility disorders in the pathogenesis of EC, prokinetics – drugs that normalize the motility of the gastrointestinal tract, improve the function of the lower esophageal sphincter, occupy a significant place in the treatment of such patients. Prokinetics increase LES pressure, improve esophageal clearance and gastric emptying.

H ₂ histamine receptor blockers. The emergence of this group of drugs has opened an era of effective drug therapy to reduce the secretion of hydrochloric acid. Appeared in the 1970s, they played a big role in the treatment of gastric and duodenal ulcers. However, these drugs were less effective in treating reflux esophagitis. Currently, there are 5 generations of H ₂ -blockers: I generation – cimetidine; II – generation – ranitidine; III generation – famotidine; IV generation – nizatidine; V generation – roxatidine. Currently, drugs from the group of ranitidine (zantac, ranitin) and famotidine (quamatel, famosan, gastromsidine) are most widely used, which are prescribed mainly for catarrhal forms of EC. These drugs effectively reduce the basal secretion of hydrochloric acid in the stomach and inhibit the secretion of pepsins. In the treatment of patients with erosive forms of the disease, they often turn out to be insufficiently effective even when taking double doses (600 mg of ranitidine and 80 mg of famotidine per day) and therefore gave way to their place inhibitors H ⁺ , K ⁺ py) , which is currently the most powerful antisecretory drugs.

Proton pump inhibitors (omeprazole, lansoprazole and pantoprazole) were introduced into clinical practice in the late 1980s [7]; rabeprazole and esomeprazole appeared not so long ago. Usually also given in double doses (omeprazole 40 mg, lansoprazole 60 mg, pantoprazole 80 mg), they achieve healing of esophageal erosions in 85-90% of patients, including those resistant to H ₂ -blockers. The drugs of this group are practically devoid of side effects since they exist in the active form only in the parietal cell.

At the same time, recent studies have shown that when using the usually recommended therapeutic dose of omeprazole (20 mg 2 times a day), approximately 20% of patients with EC retain pronounced changes in intraesophageal pH, and in almost 1/3 of patients, doses of omeprazole significantly exceeding standard therapeutic doses (up to 140 mg per day) are required to obtain a therapeutic effect.

The main course of treatment of EC exacerbations (especially erosive and ulcerative forms of EC) requires at least 8-12 weeks. At the same time, discontinuation of medication after achieving healing of esophageal erosions in many patients leads to a rapid recurrence of the disease. Therefore, many patients require maintenance treatment with proton pump blockers or prokinetics (in half daily doses) for at least 1 year, which allows maintaining disease remission in most patients.

Complications of taking antisecretory drugs .

According to recent publications, the number of patients with partial or complete non-response to the standard dose of PPI (once a day for 8 weeks) is 40-50%.

The “ rebound syndrome ” described in the literature leads to a sharp increase in gastric secretion after the withdrawal of antisecretory therapy due to hypergastrinemia. The development of the “rebound” syndrome was noted already after 2-4 weeks of taking h3-blockers and 6-8 weeks of taking PPIs . Of course, a sharp increase in acid secretion can provoke an acute ulcer, but this probability is higher with the use of H ₂ -blockers.

The existing “ fatigue syndrome” of receptors is clinically significant and characteristic of all drugs of the h3-histamine receptor blocker group. It is known that after 5-7 days of continuous use of H2-blockers, the effectiveness of therapeutic doses is reduced by more than 50%, and with longer use, the antisecretory effect is completely lost.

The literature describes the phenomenon of “nocturnal acid breakthrough” – a decrease in pH in the stomach below 4.0 for several hours in the period from 22 to 6 hours while taking PPIs. The development of this phenomenon was found in almost 70% of patients with reflux esophagitis and 80% of patients with Barrett’s esophagus, and is probably associated with an increase in the activity of the vagus nerves at this time and a decrease in the production of mucus by additional cells. licobacter pylori, which is described in more detail in the corresponding chapter.

Many authors confirm a 2-3-fold increase in the risk of developing diarrhea caused by Clostridium difficile against the background of long-term PPI therapy.

The relationship between long-term PPI use and fractures is still debatable. The review by L. Laine compared the data of 13,556 patients with hip fractures older than 50 years and 135,386 persons who made up the control group matched by sex and age for PPIs. An increased risk of hip fracture has been shown with PPI use for more than a year, with the highest risk seen with long-term high (>1.75) daily PPI use.

Patients with gastroesophageal reflux who take antisecretory drugs for a long time are at risk of developing pneumonia

Conservative measures in patients with complications of reflux esophagitis are often at the same time preoperative preparation. Bougienage in patients with peptic stricture of the esophagus should be carried out under the cover of a massive antiulcer patient. Since the exacerbation of chronic esophagitis occurs against the background of mechanical damage and irritation, and the expansion of the stricture facilitates gastroesophageal reflux, immediate antireflux intervention is necessary soon after the completion of the course of bougienage.

Omeprazole for hiatal hernia: Omeprazole for Hiatal Hernia Reviews

Omeprazole for Hiatal Hernia Reviews

Omeprazole rating summary

Reviews for Omeprazole

Frequently asked questions

Are you taking this medicine?

More FAQ

Learn more about Hiatal Hernia

Care guides

Symptoms and treatments

More about omeprazole

Patient resources

Other brands

Professional resources

Related treatment guides

Hiatal hernia is the key factor determining the lansoprazole dosage required for effective intra-oesophageal acid suppression

Affiliation

Authors

Affiliation

Abstract

Similar articles

Cited by

Publication types

MeSH terms

Substances

Gastroesophageal reflux disease (GERD). Hernia of the esophageal opening of the diaphragm (HH). | Center for Endosurgical Technologies

5

Leave a Reply Cancel reply