Randomized, placebo-controlled trial of gastric acid-lowering therapy on duodenal polyposis and relative adduct labeling in familial adenomatous polyposis

• Published in: Diseases of the colon & rectum Vol. 44; no. 11; pp. 1585 - 1589
• Main Authors: Wallace, Marina H, Forbes, Alastair, Beveridge, Iain G, Spigelman, Allan D, Hewer, Alan, Venitt, Stan, Phillips, Robin K. S
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Secaucus, NJ The ASCRS 01.11.2001; Springer
• Subjects: Adenomatous Polyposis Coli - drug therapy; Adenomatous Polyposis Coli - genetics; Administration, Oral; Adult; Anti-Ulcer Agents - pharmacology; Bile - chemistry; Biological and medical sciences; Digestive system; DNA Adducts; Double-Blind Method; Duodenal Neoplasms - drug therapy; Duodenal Neoplasms - genetics; Endoscopy; Female; Gastric Acid; Humans; Intestinal Polyps - drug therapy; Intestinal Polyps - genetics; Male; Medical sciences; Pharmacology. Drug treatments; Ranitidine - pharmacology; Treatment Outcome; Human; Rectal disease; Duodenal disease; Duodenum; Antiulcer agent; Familial adenomatous polyposis coli; Biological activity; Colonic disease; Chemotherapy; Randomization; Ranitidine; Digestive diseases; Intestinal disease; Complication; Clinical trial; Benign neoplasm; Polyp
• ISSN: 0012-3706; 1530-0358
• DOI: 10.1007/BF02234376

PURPOSE:Bile has been implicated in the pathogenesis of duodenal polyps in patients with familial adenomatous polyposis. In vitro experiments have shown that familial adenomatous polyposis bile is capable of producing DNA adducts. This effect can be ameliorated by increasing the pH of the incubate. The aim of this double-blind randomized placebo-controlled trial was to examine the effect of oral ranitidine on duodenal polyposis in a group of patients with familial adenomatous polyposis. METHODS:Twenty-six patients with familial adenomatous polyposis were randomly assigned to ranitidine 300 mg daily or placebo for six months after baseline endoscopy. Polyp counts were performed and biopsy specimens taken to detect DNA adducts byP-postlabeling. RESULTS:No difference was seen in polyp numbers (P =0.9) or relative adduct labeling (P =0.7) after treatment with ranitidine or placebo. DISCUSSION:Acid suppression therapy does not seem to improve duodenal polyposis despite in vitro findings. On the other hand, ranitidine does not exacerbate actual (or markers of) neoplasia in this highly tumor-prone condition.