Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0013395 (dyspepsia)
 4,879 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The effect of a pepsin-inhibiting pentapeptide, pepstatin, upon the peptic activity and gastric acidity was investigated in 9 men with ulcer dyspepsia and a high acid output. Subtotal inhibition of peptic activity was obtained, basally as well as after broth stimulation, as early as 15 minutes after the method of administration, and the inhibition remained almost unchanged during the 60 minutes of the experimental period. The acidity was not affected by pepstatin. No side-effects occurred. The results confirm preliminary reports on the pepsin-inhibitory activity of the drug. It is concluded that pepstatin ought to be investigated with regard to its clinical effect upon peptic ulcer.
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PMID:Effect of a pepsin-inhibitory pentapeptide upon the peptic activity and acidity of gastric secretion. 78 87

After a brief introduction regarding 24-hours gastric pH monitoring and a description of the instruments used, indications and the analysis of findings, the authors report their personal experience based on the study of 4 groups of subjects (healthy, hyersecretory, hyposecretory, dyspeptic). The analysis of pH-metries observed in these subjects show that 24-hour monitoring of gastric pH is a reliable method for assessing hypersecretion or hyposecretion of gastric acidity, whereas it is only of relative importance in essential dyspepsia. The authors therefore indicate the parameters to be taken into account in the evaluation of pH-metry findings in hypersecretory patients: 1) the percentage time of which pH is less than 1 (mean value 46.20 +/- 28.2);2) the pH pattern assessed according to the circadian rhythm which shows a prandial and post-prandial tamponade which is lower than normal with a rapid return of pH to extremely low values; 3) the visual graphic assessment for an overall judgement of pH patterns; and in hyposecretory patients: 1) the percentage time for which pH is higher than 7 (mean value 47.92 +/- 52.08); 2) enhanced pH levels ranging between 0 and 4 (mean percentage 9.67 divided by 27.08); 3) pH values at times 0, 1, 2, 3 which confirm hyposecretion in the meal causes a marked and long-lasting tamponade with pH levels above 6-7. Even in these cases the visual graphic assessment is important for an overall definition of 24-hour ph patterns.
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PMID:[Indications and limitations of 24-hour gastric pH-metry. Personal experience]. 187 26

Although numerous NSAIDs are available for use in the management of rheumatic disease, most of the members of this large class of drugs possess very similar characteristics. The great majority are acidic compounds. The acidity of the drugs allow distribution not only into inflamed tissues but also the kidneys and gastric mucosa. It is likely that these compounds produce anti-inflammatory analgesia by inhibiting prostaglandin synthesis. As a result of these similarities, NSAIDs have in general relative similar efficacy and toxicity when used in appropriate dosages. Common adverse effects include dyspepsia, gastritis, mucosal ulcers, interstitial nephritis and acute renal failure. Most of the adverse effects associated with the clinical use of these drugs are related to their effect on prostaglandin production. In some susceptible individuals, the inhibition of prostaglandin synthesis may result in a potentially fatal bronchospastic episode. Most clinical trials fail to consistently distinguish between NSAIDs. Patients however often develop distinct preferences for certain NSAIDs. The reason for this is still obscure but may reflect subtle pharmacological differences between these drugs. NSAIDs with short half-lives are quite effective on an 8 or 12 hourly dosage regimen. Compounds with longer half-lives may be associated with accumulation in the elderly and hence a higher risk of toxicity. The use of NSAIDs in the management of rheumatic disease should therefore be highly individualised.
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PMID:NSAIDS--a consideration of their efficacy and toxicity. 265 71

With appendicitis, elderly patients commonly delay 2 or 3 days after symptoms begin before seeking medical attention, the patient often attributing the abdominal discomfort to indigestion, "gas," or constipation. Reduced gastric acidity secondary to gastric surgery, aging, or medications can increase susceptibility to many enteric pathogens, leading to a higher risk of infectious diarrhea.
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PMID:Intra-abdominal infections in the elderly: diagnosis and management. 394 22

The microbial flora and some of its metabolites and enzymes in the stomach were compared in patients with achlorhydria, pernicious anaemia, and primary hypogammaglobulinaemia and in patients with dyspepsia with normal gastric acidity. Detailed analysis of the flora of the gastric juice and of the mucosa from the antrum, body, and fundus in six patients with hypogammaglobulinaemia (mean pH 8.2), seven patients with pernicious anaemia (mean pH 7.3), and five patients with dyspepsia (mean pH 1.9) yielded 22 different genera of bacteria, mainly from the patients with achlorhydria, the most common being streptococci, micrococci, staphylococci, veillonella, and lactobacilli. A similar flora was found associated with the mucosa at all three sites. Various metabolites were also looked for. beta Glucoronidase and C14 lipase were found in patients with hypogammaglobulinaemia but not in those with pernicious anaemia or dyspepsia. Volatile fatty acids were not found. Relatively high concentrations of ethanol were found in the patients with hypogammaglobulinaemia compared with those with pernicious anaemia (p = 0.02). Similar concentrations of dimethylamine were found in all three groups, but the concentrations of trimethylamine were much higher in patients with pernicious anaemia and hypogammaglobulinaemia. The high concentrations of some microbial enzymes and ethanol differentiated the group with hypogammaglobulinaemia from the rest, and these may bear some relation to the high incidence of gastric cancer in patients with hypogammaglobulinaemia.
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PMID:Microbial and metabolic profile of achlorhydric stomach: comparison of pernicious anaemia and hypogammaglobulinaemia. 403 Nov 6

The incidence and relationship of intestinal metaplasia of the gastric antrum and gastric metaplasia of the first part of the duodenum were studied in endoscopic biopsies from 120 patients with nonulcer dyspepsia. Intestinal metaplasia was present in 29% of antral biopsies and gastric metaplasia in 39% of duodenal biopsies, with 9% of patients having both. Intestinal metaplasia was not related to alcohol consumption, but was significantly higher in patients who smoked 10 cigarettes or more daily. (P less than 0.002). Gastric metaplasia was associated with duodenitis. Its incidence was significantly higher in males (P less than 0.001) and in patients with a history of high/moderate alcohol intake (P less than 0.02); these findings are reminiscent of the presence of a similar relationship between these factors and duodenal ulcers and support the suggestion that duodenitis and duodenal ulcers probably represent different parts of a single disease spectrum. The presence of both types of metaplasia in 9% of the patients suggest that factors other than gastric acidity may influence the development of metaplasia.
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PMID:A study of incidence and relationship of intestinal metaplasia of gastric antrum and gastric metaplasia of duodenum in patients with nonulcer dyspepsia. 670 42

Patients with dyspepsia were asked to volunteer for two gastric secretion tests preceded by a single intravenous injection of pirenzepine 10 mg in the one and 0.9% saline in the other (in random order). In each test gastric secretion was aspirated continuously. 0.9% saline was infused intravenously for 30 minutes followed by insulin 0.15 micrograms/kg-h for 90 minutes, saline for 30 minutes and finally pentagastrin for 90 minutes in doses of either 6, 1, 0.5 or 0.25 micrograms/kg-h. Gastric samples were analysed for volume, pH, titratable acidity and pepsin. Basal outputs of acid and pepsin were not altered by pirenzepine. Insulin-stimulated acid output was significantly reduced (p less than 0.05) from a mean of 32.7 to 22.6 mmol/h (-31%). The mean percentage reduction was 16%. Acid and pepsin outputs after pentagastrin 0.25-6 micrograms/kg-h were not significantly altered by this dose of pirenzepine.
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PMID:Influence of intravenous pirenzepine on gastric acid and pepsin in man. 678 94

From each of 2 tetanic herds and 1 control herd 20 cows were randomly selected to determine serum levels of Mg, Ca, inorganic P, Na, K, Cl-, total protein, urea, GOT-activity and blood-glucose level. In rumen fluid the number of ciliates, ammonia, level, pH and total acidity were examined. Haematological investigations were carried out. Moreover dry matter and height of the herbage were measured, and meteorological measurements were utilized. The investigations were carried out before grazing and than on the 4th, 8th, 12th, and 16th day of grazing. Symptoms of metabolic disturbances and alcalic indigestion were found to be more distinct in the tetanic herds than in control herd. The method of MgO-pulverization on pastures was found to be useless. On the other hand, MgO-food-supplementation according to generally known methods was found to be of high usefulness. MgO-treatment at a dose of 50 g per cow and day in a period of 14 days before grazing effectively prevented the outbreak of hypomagnesaemia in spite of such tetanogenic factors as unfavourable weather, insufficience of dry matter in the herbage and subclinical alcalic indigestion with disturbed nitrogen metabolism.
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PMID:[Effect of preventive treatment of acute hypomagnesemia on the biochemical and morphological indicators in cows during the grazing period]. 716 97

The symptoms of repeatedly swallowing what the patient believes is a postnasal discharge, lump in the throat, and constantly having to clear the throat are commonly encountered in patients who do not show any evidence of sinusitis or organic lesions in the upper gastro-intestinal tract or larynx. It is suggested that incompetence of the lower oesophageal sphincter could lead to the creation of this situation by lowering the pH in the oesophagus and initiating inco-ordinate peristaltic movement. A trial of treatment of 54 patients, selected on a nonrandomized consecutive basis and presenting with the above symptoms, was undertaken, treatment being aimed at increasing the cholinergic activity of the oesophageal smooth muscle and neutralizing acidity. Metoclopramide (Maxolon, Primperan) was the cholinergic agent and polymethylsiloxane aluminium hydroxide (Asilone) was the antacid selected. Results based on symptomatic improvement showed that of 44 patients who reported for the follow-up examination, 35 (83%) had good symptomatic improvement, and 7 (16%) were unchanged. The action of metoclopramide is discussed and some of the literature reviewed. Favourable symptomatic improvement suggests that further trials using this substance, together with a placebo, on a cross-over randomized basis would be worth while. The 'lump in the throat' syndrome can be recognized by the symptom tetrad of: (i) lump in the throat; (ii) repetitive swallowing; (iii) clearing of the throat; and (iv) indigestion.
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PMID:Lump in the throat. 740 30

Antacids have served us well for over a century. In terms of peptic ulcer disease, the attitude in the late 1950s to 1970s that antacids should be taken only on demand was unjustified and erroneous. 13 recent endoscopic controlled studies have confirmed the efficacy of antacids in the healing of duodenal ulcer, achieving about 75% healing in 4 weeks. The efficacy of antacids in promoting gastric ulcer healing has been less well studied and the results are controversial. The most appropriate and economical antacid regimens for the treatment of duodenal ulcer disease should include tablets or liquid that have acid neutralising capacity of 400 mmol/day given at least an hour after meals. As a long term therapy, antacids appear to work, but need be taken in multiple daily doses, a regimen which is unlikely to meet with long term patient compliance. Patients with gastro-oesophageal reflux disorders or pregnancy-related reflux have also benefited from the usage of antacids ad libitum. Early previous studies have clearly demonstrated the efficacy of antacids in reducing gastro-oesophageal reflux and healing of reflux oesophagitis. The acidity of the gastric contents is the major determining factor in the outcome of the aspiration pneumonitis occurring during delivery. The prophylactic use of antacids during delivery has helped to reduce the severity of this complication. Similarly, the prophylactic administration of antacid aiming to maintain gastric pH between 3.5 to 7.0 has resulted in significant reduction of bleeding due to stress associated ulcers and/or erosive haemorrhagic gastritis in critically ill patients. Antacid therapy, however, is controversial in the management of nonulcer dyspepsia or nonsteroidal anti-inflammatory drug related upper gastrointestinal mucosal damage. Undoubtedly, antacids have major roles to play in the treatment of gastric acid related disorders. They have clear advantages and disadvantages when compared with the antisecretory agents. New proton pump inhibitors in particular have certainly superseded antacids and even the H2-receptor antagonists in many respects. However, the long term safety record of antacids remains unsurpassed by any of the new antisecretory agents.
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PMID:Antacids. Indications and limitations. 751 3


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