Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0038358 (gastric ulcer)
 5,179 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Cimetidine, like its predecessors burinamide and metiamide, has been shown in vitro to be a specific competitive histamine H2-receptor antagonist. In vivo, it is a potent inhibitor of histamine-stimulated gastric acid secretion in animals and man after both intravenous and oral administration. Doses sufficient to inhibit gastric secretions are without measureable effects on other physiologic systems. The main indication for cimetidine is in the treatment of duodenal ulcer and of the Zollinger-Ellison syndrome. Useful indications are treatment of gastric ulcer and pnacreatic insufficiency. Possible indications are prevention of gastrointestinal bleeding and treatment of peptic esophagitis. The neutrophil toxicity seen with metiamide has so far not been demonstrated with cimetidine; side effects with cimetidine have generally been trivial. In the future, H2-receptor antagonists are likely to become key therapeutic agents in diseases in which gastric acid-pepsin secretion plays a pathogenetic role.
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PMID:H2-receptor antagonists in perspective. 2 55

Development of histamine H2-receptor antagonists has enhanced the understanding of histamine physiology and pharmacology. The effect of H2-receptor antagonists on gastrointestinal physiology has been studied extensively. These compounds inhibit gastric acid secretion in response to all known secretagogues and, in contrast to anticholinergic drugs, markedly inhibit food-stimulated acid secretion in duodenal ulcer patients. The relative roles of H2-receptor antagonists, anticholinergic drugs and antacids in the treatment of duodenal ulcer remain to be defined. Cimetidine currently is under investigation for the treatment of duodenal ulcer, gastric ulcer, reflux esophagitis, gastrointestinal bleeding and hypersecretory states. Although the long-term safety of cimetidine has not been established, in short-term clinical trials there have been no significant subjective or objective side-effects. Assuming that toxic effects do not develop, H2-receptor antagonists should improve the treatment of acid-peptic disease.
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PMID:Histamine H2-receptor antagonists. 2 27

1. The operative technique and the postoperative results of the original pylorus-preserving gastrectomy (PPG) and those of the Maki procedure as applied to cases of total gastrectomy are reported briefly. 2. The essence of these operations is to retain the pyloric cuff of 1.0-1.5 cm in length in order to preserve sphincteric function without the use of the drainage procedure. Ingested food was seen to empty gradually and rhythmically through the pyloric ring into the duodenum thereby avoiding dumping syndrome and reflux esophagitis. 3. As gastric acidity is reduced sufficiently by PPG, this method is to be recommended for treatment of intractable gastric ulcer cases and other benign lesions in which the foci are located in the distal half of the stomach. Though the method seems to be also useful in selected cases of duodenal ulcer, stenosis at the level of the pylorus and duodenum may preclude the application of the method. 4. The Maki procedure with jejunal interposition following nearly-total proximal gastrectomy is recommended in patients whose pylorus and its surroundings have remained free of tumor.
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PMID:Pylorus-preserving procedure in partial and total gastrectomy. 32 97

The conventional treatment of peptic ulcer disease with special dietary regimens, antacids or anticholinergics has been found wanting. Recently introduced agents show considerable promise in the benefit they can render. Carbenoxolone accelerates the healing of gastric ulcers by increasing gastric mucosal resistance. Cimetidine, a histamine HI-receptor antagonist, is an effective suppressant of acid secretion and therefore promotes healing of duodenal ulcers. Metoclopramide hastens gastric emptying and increases the tone of the gastroesophageal sphincter, and is valuable in cases of reflux esophagitis and gastric ulcer.
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PMID:Symposium on peptic ulcer disease. 1. Medical treatment of peptic ulcer. 57 7

The indication for the non-resecting combination method arises if the presence of genuine ulcer disease is confirmed by complete diagnostic measures (history, roentgenologic examination, endoscopy, secretion analysis and possibly psychic testing). An extended indication exists for erosive gastritis with hypersecretion, for hiatal hernia with reflux esophagitis (Berman's syndrome), for cardiospasm and prophylaxis of hemorrhage. The technique yields permanent curative results if a complete selective proximal vagotomy is combined with a pyloroplasty suitable in form and function. This is also true for duodenal ulcer. In 22% of cases of gastric ulcer, selective vagotomy with antrectomy is necessary.
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PMID:[Non-resecting surgery for gastroduodenal ulcer. II. Indication and technique (author's transl)]. 81 5

One hundred and sixty two patients with upper and intermediate gastrointestinal hemorrhage studied under a prospective protocol are reported. Upper endoscopy revealed lesions of the upper gastrointestinal tract in 137 patients (89%); a barium swallow performed to 92 of them failed to confirm the endoscopic diagnosis in 66 (71.7%). In 99m Tc scan suggested ectopic gastric mucosa in 9 cases; Meckel's diverticulum was confirmed by laparotomy in 7 and gastrointestinal duplication in two of them. Selective mesenteric arteriography demonstrated bleeding ileo-cecal varices in one patient. The main causes of gastrointestinal hemorrhage in the current series were duodenal ulcer (22.8%), esophageal varices (14.8%), stress ulcers (14.2%), reflux esophagitis (7.4%), aspirin-induced gastritis (6.8%), gastric ulcer (5.6%) and ectopic gastric mucosa (5.6%). These diagnosis were characteristically distributed according to pediatric age-groups. The source of bleeding could be detected in 90% of the patients studied. A clinical approach to differential diagnosis of patients with gastrointestinal bleeding is presented.
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PMID:[Usefulness of endoscopy in the differential diagnosis of hemorrhage of the upper digestive tract in children]. 146 73

While waiting for open heart surgery, in 153 patients (104 male, 49 female, 22-76 years of age) without gastrointestinal symptoms and/or history esophago-gastro-duodenoscopy was performed. 124 patients suffered from coronary heart disease, 29 from valvular defect, aneurysm of the sinus of Valsalva or tumor of the heart. In 47.1% endoscopy revealed serious abnormal findings: in 16.3% gastric ulcer, in 20.9% erosive gastritis, duodenal ulcer and erosive duodenitis in 5.2%, respectively, 1 case of gastric carcinoma, 2 of large polyps and 3 of reflux esophagitis of higher degree (totally 3.9%). In patients with coronary artery disease, the relation of erosive and ulcerous gastric lesions as compared with those of duodenal origin was 4:1, in patients with other cardiac diseases it was 2:1, respectively (p less than 0.001). Compared with a normal population, the incidence of pathological gastric findings was 54-fold higher in our patients, and 1.7-fold concerning duodenal lesions, respectively (p less than 0.001). 51 patients on acetylsalicylic acid (160 mg/die) showed pathologic findings in 41.2%, and 96 patients without ulcer-inducing therapy in 51%. Thus, low-dose Aspirin does not seem to have serious gastric side effects. The results of the study stress the necessity of routinely performed endoscopy of the upper gastrointestinal tract in patients awaiting open heart surgery. This will lead to a lower incidence of serious gastrointestinal complications postoperatively which are known to have a high mortality.
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PMID:[Frequency of pathological changes of the upper gastrointestinal tract in patients awaiting heart surgery]. 208 20

Omeprazole has been shown to provide more rapid symptom relief and to heal ulcers more quickly and reliably than H2-receptor antagonists in duodenal ulcer, gastric ulcer and reflux oesophagitis. In addition, omeprazole is well tolerated and has a good safety profile. Among the areas for clinical development with omeprazole are the maintenance treatment of duodenal ulcer, treatment of non-steroidal anti-inflammatory drugs (NSAID)-induced gastro-duodenal lesions, maintenance treatment of reflux oesophagitis and the treatment of bleeding ulcer. Two studies of patients with duodenal ulcer have shown that maintenance treatment with omeprazole, 10 mg once daily, was as effective as, or superior to, treatment with omeprazole, 20 mg given on Friday, Saturday and Sunday only, and markedly superior to placebo. In patients with gastric ulcer which developed during treatment with NSAIDs omeprazole, 20 mg once daily, resulted in a higher healing rate than ranitidine, 150 mg b.i.d., both at 4 and at 8 weeks. Reflux oesophagitis is often a persistent condition requiring continuous maintenance treatment. In a recent multicentre trial, a substantially higher proportion of patients remained in remission with omeprazole, 20 mg once daily, than with ranitidine, 150 mg b.i.d. Studies comparing omeprazole and ranitidine (administered intravenously) in patients with bleeding peptic ulcers have also demonstrated the superiority of omeprazole with regard to the control of bleeding and the avoidance of surgery. Further studies are currently underway in this and other related areas.
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PMID:Clinical development programme for omeprazole. 209 16

As many as 72 patients with erosive and ulcerous injuries to the stomach and duodenum were examined for the clinical efficacy of antepsin (sucralfate). Of these patients, 42 were with duodenal ulcer, 10 with gastric ulcer and 20 with erosive gastroduodenitis). Antepsin exerted a beneficial effect on the painful syndrome and on ulcer and erosion healing. The coefficient of the therapeutic efficacy of antepsin in duodenal ulcer patients turned out to be equal to 2.67 that of gastric ulcer to 2.1 and that in patients with gastroduodenitis was 2.6. The drug did not produce any well-defined side effects. In some cases (8.3%), it caused the appearance or enhancement of constipation. Antepsin is indicated not only in ulcer disease but also in duodenogastric reflux, reflux gastritis and reflux esophagitis.
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PMID:[Sucralfate: the agent of choice in the treatment of peptic ulcer?]. 218 96

The clinical efficacy of famotidine has been clearly shown in the short- and long-term treatment of a number of acid-related diseases such as duodenal and gastric ulcer as well as in the acute management of reflux esophagitis. In addition, famotidine effectively treats anastomotic ulcer and nonulcer dyspepsia. Based on a number of considerations--chemical structure, pharmacokinetics, pharmacodynamics, clinical efficacy, tolerability, and dosage regimen--famotidine represents an end-point in the development of the H2-antagonist group of anti-ulcer agents.
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PMID:Clinical efficacy of famotidine in the treatment of acid-related diseases: an overview. 221 Jun 12


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