Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0011168 (dysphagia)
 15,644 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In a 77-year-old man with dysphagia, x-rays demonstrated an irregular stenotic process in the lower third of the esophagus, suggesting malignancy. Endoscopy disclosed moderate narrowing of the lumen and several ulcers separated by bulges. Serial biopsies revealed Barrett's mucosa. Cimetidine 1 g/day led to prompt improvement and endoscopically there was a disappearance of the lesions after 3 months of therapy. Reduction of the drug to 400 mg/day 3 months later with supplements of antacids and metoclopramide was followed by reappearance of symptoms and recurrence of a deep ulcer. Raising the dose of cimetidine to 1 g/day again resulted in healing and since then a maintenance dose of 600 mg cimetidine with antacids and metoclopramide has been successful in preventing recurrence. This long-term study in a patient with Barrett's esophagus showed 1) that cimetidine can be effective in treating such patients; 2) the prophylactic value of multitherapy as a maintenance regimen, and 3) the importance of careful follow-up.
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PMID:Prolonged cimetidine therapy in ulcerated Barrett's columnar-lined esophagus. 641 85

Of seven patients with Barrett's esophagus, two had acute upper gastrointestinal (GI) tract bleeding, two had slow chronic upper GI tract bleeding; and three had dysphagia and weight loss. At upper GI tract endoscopy, 1- to 2-cm ulcers were seen in all seven patients in the distal esophagus. Four of the seven patients also had stricture of varying severity in the distal esophagus. Serial esophageal mucosal biopsy specimens in all seven patients revealed specialized columnar epithelium distal to 28 cm from the incisor teeth. Five of the seven patients were treated with intensive antacid therapy for eight weeks; but the ulcers had not healed after this period of treatment as assessed endoscopically. These five patients and two more then started therapy with cimetidine, 1.2 g per day. Repeat endoscopy four weeks and eight weeks after institution of cimetidine therapy revealed complete healing of the esophageal ulcers in six of the seven patients. One patient needed 16 weeks of cimetidine therapy before his ulcer had healed completely. Cimetidine therapy was not effective in preventing restricture of the esophagus. Two patients underwent biopsy 18 months after successful treatment; gastric epithelium had not reverted to squamous epithelium.
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PMID:Barrett's ulcer and treatment with cimetidine. 736 76