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)

Inhibition of H2 receptors has been the first fully evaluated treatment of peptic ulcer and remains the most widely used mode of therapy. In this review, we summarize the current data on clinical pharmacology, therapeutic indications and results of the four currently used drugs: cimetidine - ranitidine - pepticidine - nizatidine. Their similarities are stressed. Recent data are underlined. The superiority or necessity of a single evening dose is questioned, as well as the clinical importance of tolerance and rebound. The effect on gastric alcohol dehydrogenase is mentioned pending further work on the clinical importance of this discovery. In the acute treatment, the antisecretory potency is of major importance in duodenal ulcer, the duration of treatment in gastric ulcer. Maintenance treatment prevents complication as well as recurrence. H2 receptor antagonists remain a primary treatment of peptic ulcer.
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PMID:[Currents aspects of H2 receptor antagonists in the treatment of ulcers]. 136 66

Direct comparisons of ulcer perforation rates and trends between countries have not been made in the past. Data on hospital admissions for perforated peptic ulcer during 1 January 1979 to 31 December 1985 were collected in Hong Kong (5868 perforations) and New South Wales, Australia (1669 perforations). Age and sex specific rates per 100,000 population were calculated. In Hong Kong, annual duodenal ulcer and gastric ulcer perforation rates were 13-16 and under two per 100,000 population respectively. In New South Wales, the corresponding rates were between three and four and under two per 100,000 population, respectively. The male:female ratios for duodenal ulcer perforation were consistently about 5:1 in Hong Kong and 2:1 in New South Wales, and for gastric ulcer perforation about 2:1 and 1:1, respectively. The incidence of perforation increased with age, and there was a statistically significant rise, over time, in duodenal but not gastric ulcer perforation rates in persons aged over 60 years in New South Wales; similar trends were seen in Hong Kong. Thus duodenal ulcer perforation occurs five times more commonly in Hong Kong than in New South Wales and this is largely accountable for by the higher rates of duodenal ulcer perforation in Chinese than in Australian males. Such geographical differences can best be explained by the occurrence of multiple aetiological mechanisms in ulcer perforation. Furthermore, there appears to be an increased susceptibility and an appreciable rising trend for duodenal ulcer perforation to occur in the elderly.
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PMID:Perforated peptic ulcer in Hong Kong and New South Wales. 139 32

Since the advent of H2-receptor antagonists, elective ulcer surgery is rare. The need for operation for complications of peptic ulcer disease, however, remains unchanged. Highly selective vagotomy is the elective operation of choice for duodenal ulcer worldwide. It has few side effects and a mortality that approaches 0%. Unfortunately, ulcers recur in 10% to 15% of patients, a much higher recurrence rate than that seen with vagotomy and antrectomy (less than 1%). The latter operation, however, is associated with significant side effects, such as dumping syndrome and diarrhea, and a higher operative mortality. The elective operation of choice for gastric ulcer is antrectomy. Recent prospective trials show that highly selective vagotomy should be performed routinely at the time of closure of perforated duodenal ulcer. Neither morbidity nor mortality is increased with the procedure, and the 40% to 60% ulcer recurrence rate with closure alone is reduced to 2% to 8%.
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PMID:Surgical management of peptic ulcer disease. 139 8

Chronic gastritis is a common inflammatory disease. In a number of patients, the inflamed gastric mucosa shows a gradual tendency to become atrophic (atrophic gastritis). Gastritis tends to be lifelong, and spontaneous healing is rare. With very few exceptions (e.g. in patients with autoimmune chronic corpus gastritis), gastritis is associated with the presence of the bacterium Helicobacter pylori. Inflammation and atrophy of the gastric mucosa result in impairment of gastric secretory functions (e.g. secretion of gastric acid, pepsin and gastrin). Such impairment is dependent on the topographic type of gastritis; i.e. whether the inflammation and atrophy occur in the antrum (chronic antral gastritis), corpus (chronic corpus gastritis) or in both the antrum and corpus simultaneously (chronic pangastritis). Gastritis of different topographic types associates with different gastric diseases. In patients with H. pylori-related antral or pangastritis, peptic ulcer disease, and in particular duodenal ulcer, is common (with an incidence exceeding 20% after 10 years' follow-up), as compared with peptic ulcer disease, which is very rare in patients with a normal stomach. Gastric ulcer may sometimes occur in patients with a rather atrophic stomach, but both gastric and duodenal ulcers are extremely rare in patients in whom the gastritis accompanies severe atrophic changes in the corpus mucosa. Routine biopsies from the antrum and corpus, and interpretation of the results in the light of the data on gastritis and its atrophic sequelae, allow the gastroenterologist to predict the risk and likelihood of peptic ulcer disease in patients with gastritis.
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PMID:Natural history of gastritis and its relationship to peptic ulcer disease. 139 47

The development of gastric enterochromaffin-like (ECL)-cell hyperplasia in humans may be associated with extreme hypergastrinaemia, as occurs in Zollinger-Ellison syndrome (ZES) and pernicious anaemia (type A gastritis). More recently, endocrine cell hyperplasia has been found in all forms of chronic atrophic gastritis and even in cases of focal atrophy. Serum gastrin levels, non-antral gastric endocrine (argyrophil) cell growth, and the severity and type of concomitant gastritis were monitored in 66 unoperated and 8 antrectomized patients with poorly responsive peptic ulcer or reflux oesophagitis during up to 5 years' treatment with high-dose omeprazole, 40 mg daily. A small subgroup of patients (23%) had serum gastrin concentrations of more than four times the normal upper limit. These patients also had hyperplasia of the gastric argyrophil cells. More importantly, the same subgroup of patients had high-grade (atrophic) gastritis. Micronodular hyperplasia of argyrophil cells was significantly more frequent in biopsies showing atrophic gastritis (48%) than in biopsies showing only superficial gastritis (3.6%). It is concluded that, as previously demonstrated in untreated patients with gastric ulcer, the argyrophil cell hyperplasia observed during high-dose omeprazole therapy is related to the progression of chronic atrophic gastritis rather than to serum gastrin levels.
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PMID:Inter-relationship between serum gastrin levels, gastric mucosal histology and gastric endocrine cell growth. 139 48

The authors analyse the methods of treatment for the peptic ulcer disease (PUD) in two 5-year periods (group A 1979-1983, group B 1985-1989). From these groups patients with perforated gastroduodenal ulcer were excluded. In the first period 206 operations were carried out using nearly exclusively classical partial gastrectomies of both types (94 per cent). The second period involves 94 operations, where the most frequent type of operations was the proximal gastric vagotomy (40.4 per cent), and vagotomy with anthrectomy in the Roux-en-Y modification (26.6 per cent). The number of operations for a complicated PUD has increased from 43.2 per cent to 53.2 per cent, the ratio between the duodenal and gastric ulcer has changed from 3:1 to 2:1. The mortality was 5.3 and 4.7 per cent respectively, the morbidity 14.5 and 13.8 per cent respectively. The authors confirmed their accordance with the world-wide trend of diminution of the proportion of surgically treated PUD and a shift in the pattern of surgical methods towards the non-resective and more physiological procedures.
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PMID:The changing pattern in peptic ulcer surgery. 141 Dec 39

This review presents a critical evaluation of the role of Helicobacter pylori eradication in the management of peptic ulcer disease and non-ulcer dyspepsia. On current evidence, H. pylori eradication therapy seems likely to emerge as the most rational and cost-effective treatment for duodenal ulcer. The role of H. pylori eradication in the treatment of gastric ulcer and non-ulcer dyspepsia is unclear and requires further study. The emerging problem of antibiotic resistance in H. pylori is of major clinical importance and a prime cause of treatment failure. There is increasing evidence of a link between H. pylori and gastric cancer but it is premature to recommend large-scale eradication of H. pylori as a valid strategy for the primary prevention of gastric cancer. The search continues for the ideal H. pylori eradication regimen.
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PMID:Eradication of Helicobacter pylori: therapies and clinical implications. 143 52

Fungal gastric ulcer is a relatively frequent from of gastric mycosis coexisting in 20-30% of cases with peptic ulcer. In such cases fungi were present in patients without other disease and in those with concomitant diseases such as neoplasms, polyps of the stomach, haematological diseases, and in patients treated with cytostatics and H2-blockers. Fungal ulcer differ from common ulcers in greater size and tendency for bleeding. In certain situations "fungal ulcer" requires routine antimycotic treatment especially if operation is planned.
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PMID:[Fungal stomach ulcer]. 144 28

We measured gastric and duodenal mucosal prostaglandin concentrations in 69 patients with active or inactive duodenal or gastric ulcer disease and 26 non-ulcer controls. Each underwent endoscopy enabling us to obtain multiple biopsies from the gastric body and antrum and from the duodenal bulb and postbulbar duodenum for measurement of mucosal prostaglandin concentrations, as well as a single biopsy from each region for mucosal histology. Using a multivariate linear regression model, we found that neither gastric nor duodenal ulcer disease significantly affected gastric or duodenal mucosal prostaglandin concentrations. Mucosal prostaglandin concentrations were similar at the edge of the ulcer and in the adjacent non-ulcerated mucosa. Neither gender symptoms, smoking, use of H2-receptor antagonists, disease activity, nor Helicobacter pylori infection had an independent effect on mucosal prostaglandins in any region. Gastritis in the body of the stomach was associated with significantly higher prostaglandins, while older age was associated with significantly lower gastric and duodenal prostaglandins. Gastroduodenal mucosal prostaglandins are thus not altered in patients with active or inactive peptic ulcer disease, even when multiple demographic and histologic variables are taken into consideration.
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PMID:Gastric and duodenal mucosal prostaglandin concentrations in gastric or duodenal ulcer disease: relationships with demographics, environmental, and histological factors, including Helicobacter pylori. 144 36

Gastroendoscopic biopsy specimens from 366 patients were stained with HE, Warthin-Starrys or Giemsa and mucin histochemical methods. Positive rate of Helicobacter pylori (HP) was 73.8% in chronic gastritis. Positive rates of HP in gastric ulcer disease were 88.2%, 91.9%, and 11.1% at the near and distant mucosa of ulcer and in duodenitis, respectively. Positive rates of HP in duodenal ulcer disease were 81.5%, 24.6% and 7.2% at the pyloric-antral area and at the near and distant mucosa of duodenal ulcer, respectively. The number of HP in active inflammation was higher than that in inactive inflammation (P < 0.05). The HP almost lived in the neutral mucin. There was no statistical significant difference between near and distant mucosa of ulcer (P > 0.05). HP might play an important role in the pathogenesis of chronic gastritis, and it might aggravate the peptic ulcer disease.
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PMID:[A study on the pathogenicity of Helicobacter pylori in chronic gastritis and peptic ulcer disease]. 145 59


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