Sucralfate for the prevention of early rebleeding following injection sclerotherapy for esophageal varices

• Published in: Hepatology (Baltimore, Md.) Vol. 10; no. 3; p. 279
• Main Authors: Polson, R J, Westaby, D, Gimson, A E, Hayes, P C, Stellon, A J, Hayllar, K, Williams, R
• Format: Journal Article
• Language: English
• Published: United States 01.09.1989
• Subjects: Combined Modality Therapy; Esophageal and Gastric Varices - etiology; Esophageal and Gastric Varices - mortality; Esophageal and Gastric Varices - therapy; Esophageal Diseases - etiology; Female; Gastritis - etiology; Gastrointestinal Hemorrhage - etiology; Gastrointestinal Hemorrhage - mortality; Gastrointestinal Hemorrhage - therapy; Humans; Liver Diseases - complications; Liver Diseases - pathology; Male; Middle Aged; Recurrence; Sclerosing Solutions - adverse effects; Sclerosing Solutions - therapeutic use; Sucralfate - adverse effects; Sucralfate - therapeutic use; Time Factors; Ulcer - etiology
• ISSN: 0270-9139
• DOI: 10.1002/hep.1840100304

One hundred eighty patients with variceal bleeding and treated by long-term sclerotherapy were randomized into a prospective randomized controlled clinical trial to assess the efficacy of sucralfate in reducing the frequency of rebleeding from esophageal ulceration prior to variceal obliteration. Overall, 29 (32%) of the 92 patients treated with the addition of sucralfate rebled, compared to 37 (42%) of 88 patients managed by sclerotherapy alone (p less than 0.10), but when patients with well-compensated liver disease were considered, the respective figures were 14 (24%) and 25 (42%)--a statistically significant difference (p less than 0.05). The frequency (approximately 70%), number (per patient) and extent of sclerotherapy-induced esophageal mucosal ulceration were not different for the two groups, although proven rebleeding from the ulceration occurred less frequently in those receiving sucralfate (10 and 20 occasions, respectively, p less than 0.05). Mortality was not different for the two groups. Thus, use of sucralfate will reduce the frequency of rebleeding during long-term treatment by sclerotherapy, although benefit appears to be restricted to well-compensated patients and without an endoscopic overt effect upon esophageal mucosal ulceration.