ArticleClinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association2017
Opened Proton Pump Inhibitor Capsules Reduce Time to Healing Compared With Intact Capsules for Marginal Ulceration Following Roux-en-Y Gastric Bypass.
Article in Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05799105 (OPEN Versus InTact Capsule Proton Pump Inhibitors for the Treatment of Marginal Ulcers After Bariatric Surgery), which is not on this map. Cited by 27 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
OPEN Versus InTact Capsule Proton Pump Inhibitors for the Treatment of Marginal Ulcers After Bariatric Surgery
Who cites it
27 citing papers in PubMed, 1 synthesis or guideline pooled it, 61 citations in OpenAlex.
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- Gatherings in Esophagology: Innovations and Future Directions in the Diagnosis and Management of Reflux Disease.Annals of the New York Academy of Sciences · 2026Article
- Endoscopic jejunal flap suturing for the treatment of refractory marginal ulcers-a case series.Surgical endoscopy · 2025Article
- Transcatheter Arterial Radioembolization-Induced Gastric Ulcer in an Excluded Stomach After Roux-en-Y Gastric Bypass.ACG case reports journal · 2024Article
- Early Marginal Ulcer After Roux-en-Y Gastric Bypass: MBSAQIP Database Analysis of Trends and Predictive Factors.Obesity surgery · 2024Article
- Marginal Ulcer Incidence and the Population of Gastrin Producing G cells Retained in the Gastric Pouch after Roux-en-Y Gastric Bypass: Is There a Relationship?Obesity surgery · 2024Article
- The Effects of Bariatric Surgery on Pharmacokinetics of Drugs: a Review of Current Evidence.Current nutrition reports · 2023Review
- Marginal Ulcers after Roux-en-Y Gastric Bypass: Etiology, Diagnosis, and Management.Journal of clinical medicine · 2023Review
- Management of a refractory marginal ulcer following Roux-en-Y gastric bypass with EUS-guided Roux-en-Y gastric bypass reversal.VideoGIE : an official video journal of the American Society for Gastrointestinal Endoscopy · 2023Article
- Perioperative Interventions to Prevent Gastroesophageal Reflux Disease and Marginal Ulcers After Bariatric Surgery - an International Experts' Survey.Obesity surgery · 2023Article
- Implications of Bariatric Surgery on the Pharmacokinetics of Antiretrovirals in People Living with HIV.Clinical pharmacokinetics · 2022Review
- Revision Bariatric Procedures and Management of Complications from Bariatric Surgery.Digestive diseases and sciences · 2022Review
- Guidelines for Perioperative Care in Bariatric Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations: A 2021 Update.World journal of surgery · 2022Review
- Oral drug dosing following bariatric surgery: General concepts and specific dosing advice.British journal of clinical pharmacology · 2021Review
- Endoscopic Evaluation and Management of Late Complications After Bariatric Surgery: a Narrative Review.Obesity surgery · 2021Review
- Incidence and Prognostic Factors for the Development of Symptomatic and Asymptomatic Marginal Ulcers After Roux-en-Y Gastric Bypass Procedures.Obesity surgery · 2021Article
- Thromboembolism and Fluid Collections Years Following Gastric Bypass: the Relevance of the Remnant.Obesity surgery · 2021Article
- Ulcer Disease in the Excluded Segments after Roux-en-Y Gastric Bypass: a Current Review of the Literature.Obesity surgery · 2021Review
- Medication management and pharmacokinetic changes after bariatric surgery.Canadian family physician Medecin de famille canadien · 2020Review
Corrections and comments
Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND &
aimsMarginal ulceration, or ulceration at the gastrojejunal anastomosis, is a common complication of Roux-en-Y gastric bypass (RYGB). Acidity likely contributes to the pathophysiology, and proton pump inhibitors (PPIs) frequently are prescribed for treatment. However, patients with gastric bypass only have a small gastric pouch and rapid small-bowel transit, which limits the opportunity for capsule breakdown and PPI absorption. Soluble PPIs (open capsules [OCs]) might be absorbed more easily than intact capsules (ICs). We compared time to ulcer healing, number of endoscopic procedures, and use of health care for patients with marginal ulceration who received PPIs in OC vs IC form.
methodsWe performed a retrospective study of 164 patients diagnosed with marginal ulceration who underwent RYGB at the Brigham and Women's Hospital from 2000 through 2015. Patients received high-dose PPIs and underwent repeat endoscopy every 3 months until ulcer healing was confirmed. We used time-to-event analysis with a Cox proportional hazards model to evaluate the association between mode of PPI administration and time to ulcer healing, in addition to Cox multivariate regression analysis. Total charge (procedural and maintenance) was determined by comparison of categorized charges incurred from time of ulcer diagnosis to resolution. The primary outcome was time to healing of marginal ulceration in RYGB patients receiving high-dose PPIs in OC vs IC form.
resultsA total of 162 patients were included (115 received OC and 49 received IC). All patients were followed up until ulcer healing was confirmed. The median time to ulcer healing was 91.0 days for the OC group vs 342.0 days for the IC group (P < .001). OC was the only independent predictor of time to ulcer healing (P < .001) when we controlled for known risk factors. The number of endoscopic procedures (P = .02) and overall health care utilization (P = .05) were lower in the OC than the IC group.
conclusionsPatients with marginal ulceration after RYGB who receive OC PPIs have shorter ulcer healing times, fewer endoscopic procedures, and use less health care resources compared with patients who receive IC PPIs. Given these results and the high prevalence of marginal ulceration in this patient population, the use of OC PPIs is a low-risk, low-cost alternative that should be considered.
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