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)

The aim of the present study was to investigate whether CYP2C19 polymorphism status and gastric emptying are related to healing in patients with gastric ulcers. We studied the CYP2C19 status in seven patients with proton pump inhibitor (PPI)-resistant ulcers, 21 with PPI-sensitive ulcers and 46 healthy volunteers using polymerase chain reaction restriction fragment length polymorphism to detect CYP2C19m1 mutation in exon 5 and CYP2C19m2 mutation in exon 4. Gastric emptying was evaluated using the 13C-acetate breath test. The frequency of phenotypes, indicated by genotypes, did not differ significantly between the three patient groups. The peak time of 13C excretion in patients with PPI-resistant ulcers was significantly longer than that of patients with PPI-sensitive ulcers and healthy volunteers. Our results suggest that rate of gastric emptying, but not CYP2C19 polymorphism, is likely to be an important factor in the delayed healing of patients with PPI-resistant gastric ulcer.
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PMID:Polymorphism of CYP2C19 and gastric emptying in patients with proton pump inhibitor-resistant gastric ulcers. 1223 24

The association between Helicobacter pylori ( H. pylori) infection and idiopathic thrombocytopenic purpura (ITP) has been reported by several groups. We investigated the prevalence of H. pylori infection and the effectiveness of its eradication in Japanese patients with ITP. H. pylori infection was found in 21 of 30 patients (70.0%) by (13)C urea breath test and presence of serum antibodies to H. pylori. H. pylori was eradicated in 18 of the 21 infected patients (85.7%) by administration of a proton pump inhibitor and two kinds of antibiotics. In only one patient was medication discontinued due to skin rash on the 4th day of treatment. Platelet recovery was obtained in ten patients (55.6%). In two patients with treatment failure, platelet recovery was obtained after successful re-eradication. In three patients without H. pylori infection, platelet counts did not significantly increase with the same treatment. On the other hand, eradication therapy did not affect platelet counts in patients with gastric ulcer. In conclusion, H. pylori eradication can be used for initial treatment with tolerable adverse effects in some ITP patients.
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PMID:Platelet recovery after eradication of Helicobacter pylori in patients with idiopathic thrombocytopenic purpura. 1257 61

Pantoprazole, the third proton pump inhibitor (PPI) to become available, has been extensively investigated. Pantoprazole inhibits acid more powerfully than histamine H(2) receptor antagonists (H(2)RAs) and omperazole 20 mg and raises median 24-h gastric pH from about 1.5 to 3-4 in healthy volunteers and in duodenal ulcer patients to above 5. Results from studies have confirmed that pantoprazole is superior to H(2)RAs in speed of healing and symptom relief in patients with peptic ulcer. In patients with duodenal ulcer pantoprazole was as effective as omperazole 20 mg and in patients with gastric ulcer pantoprazole was statistically superior to omeprazole 20 mg after 4 weeks. In triple combination therapy of peptic ulcer disease, the mean eradication rate of Helicobacter pylori in data pooled from 32 pantoprazole-based studies was 86% and compliance with treatment was about 90%. Results pooled from 5 large clinical trials of gastroesophageal reflux disease showed healing rates significantly superior to those achieved with H(2)RAs and similar to those of other PPIs at 4 and 8 weeks. Symptom relief was more rapid with pantoprazole and maintenance treatment kept the majority of patients in remission; relapse rates at 1 year were 25-28% on 20 mg daily and 6-22% on 40 mg daily. Maintenance treatment with pantoprazole 40 mg has been shown to keep most patients with aggressive or refractory ulcer and reflux disease in remission for up to 3 years. Pantoprazole was also effective in the management of patients with Zollinger-Ellison syndrome. In volunteers given aspirin, pantoprazole 40 mg proved significantly superior to ranitidine and placebo in preventing the development of mucosal damage and was significantly better than placebo in preventing gastric ulcer and duodenal ulcer in arthritic patients on nonsteroidal antiinflammatory drugs. Clinical trials, postmarketing surveillance and long-term studies have confirmed that pantoprazole is effective and safe for the short- and long-term management of peptic ulcer and reflux disease, with side effects similar in incidence and type to those of H(2)RAs.
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PMID:Pantoprazole: a new proton pump inhibitor in the management of upper gastrointestinal disease. 1297 72

Gastrozolum is the proprietary name of a drug made in Saint Petersburg. Its international nonproprietary name is Omeprazole. The absorption rate is not related to food. Its pharmacotherapeutic action becomes apparent as an inhibitor of the proton pump leading to the inhibition of H+/K(+)-ATPase of the secretory membrane of parietal cells of the stomach mucous membrane and blocking of the concluding stage of hydrochloric acid secretion. The entire action leads to the decrease of the level of basal and induced secretion regardless of the nature of stimulus. As a result of this, symptoms of stomach ulcer decrease, and gastroduodenal ulcers heal faster. Penetrating into the stomach mucous membrane cells, the drug also has a cytoprotective action. The maximum blood concentration (0.6-1.5 mg/l) is found 2-3 hours after a single intake of 40 mg of the drug. It was determined that after the intake of 20 mg of Gastrozolum its action lasts for 24 hours and provides for the inhibition of both night and day secretion. The ricochet syndrome does not take place when the treatment is over. It was proved that Gastrozolum has a bactericidal action on Helicobacter pylori due to the sharp increase of stomach pH, which contributes to the realization of the effect of used components of the anti-helicobacter therapy. The experiment failed to establish any teratogenic or poisonous action on the embryos. The dosage form is a capsule containing 20 mg of Omeprazole in the form of pellets.
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PMID:[Therapeutic effect of gastrozolum in stomach ulcers]. 1462 6

Eradication of H. pylori provides a potential cure in the majority of patients with gastric ulcer as well as duodenal ulcer. Two proton pump inhibitor(PPI)-based triple therapy, combining with clarithromycin(CAM), amoxicillin(AMPC) or metronidazole have been established as standard regimens worldwide. In Japan, lansoprazole(LPZ)-based triple therapy combined with CAM and AMPC for 1 week was firstly investigated on eradication effect against H. pylori and determination of the optimal dose of CAM in multicenter, double-blind trial. Patients with active gastric ulcer or duodenal ulcer were enrolled in this study. The eradication rate of H. pylori in patients with gastric ulcer were 0%, 87.5% and 89.2% and those in patients with duodenal ulcer were 4.4%, 91.1% and 83.7% in LPZ(60 mg/d) alone, LPZ(60 mg/d) with CAM(400 mg/d) and AMPC(1,500 mg/d), LPZ(60 mg/d) with CAM(800 mg/d) and AMPC(1,500 mg/d), respectively, in the full set analysis. LPZ-based triple therapy demonstrated a high eradication rate and was safe. In addition, the combination regimens with lower or higher dose of CAM were equivalent in Japanese patients.
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PMID:[Eradication effect of lansoprazole-based triple therapy against H. pylori]. 1503 91

Peptic ulcer recurrence after successful eradication of Helicobacter pylori(H. pylori) is not rare. We evaluated the effect of H. pylori eradication on prevention of gastric ulcer recurrence. Ulcer recurrence had occurred in 20 of 256 H. pylori-eradicated patients, and most of ulcer recurrence were found within 1 year after eradication. NSAIDs and psychological stress, but not sex, smoking habit, drinking habit, and past history of ulcer, seem to be associated with ulcer recurrence. Intractable ulcers after the eradication of H. pylori frequently recurred. Some recurrent ulcers were refractory to treatment with H2-receptor antagonists or proton pump inhibitors. The mechanism(s) by which healed ulcers recur after successful eradication of H. pylori remains unclear.
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PMID:[Peptic ulcer recurrence after successful eradication of Helicobacter pylori--clinical characteristics and management]. 1503 93

A study group supported by Ministry of Health, Labor and Welfare recently reported the Japanese guideline for gastric ulcer treatment which suggests that gastric ulcer can be cured by either H. pylori eradication or acid suppression therapy by proton pump inhibitors(PPI) and H2-receptor antagonists(H2RA). It also suggests that all mucoprotective drugs except sucrafate, misoprostol and enprostil can't be recommended for gastric ulcer treatment. However, some mucoprotective drugs have been shown to possess anti-inflammatory action, leading to the inhibition of leucocyte infiltration in H. pylori gastritis, while long-term usage of PPI and H2RA might worsen gastritis. Thus, mucoprotective drugs should be investigated in terms of long-term effects on H. pylori-gastritis rather than the effects on gastric ulceration.
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PMID:[The role of mucoprotective drugs in gastric ulcer treatment: with specifical reference to their effects on gastritis mucosa]. 1503 5

There are many reported methods in the literature for the discrimination between malignant and benign gastric ulcers by endoscopic evaluation, but unfortunately this could not be done in 20% of the cases. The sensitivity for diagnosis of malignant ulcers increases by multiple biopsies and endoscopies. In this study, solitary gastric ulcers which were detected at 1680 gastroscopies between January 2001 and June 2002 are evaluated. The ulcers which were on gastric mass, multiple little aphthous ulcers and ulcers with hemorrhagic erosions having a diameter less than 0.5 cm are excluded from the study. There were a total of 32 patients, 20 males and 10 females, having a median age of 54.8 years. In the initial biopsy, only nine patients had malignancy results. The 23 cases having benign results had medical treatment with proton pump inhibitors for four weeks. At the end of this period, they had their second gastroscopic evaluation. The ulcers of 14 patients did not heal and second round biopsies were per formed. Additionally four cases had malignant results following the second round biopsy. After 4 weeks the remaining 10 cases had their third round of gastroscopy which revealed that two patients still had the ulcer. A third round biopsy was done and one case had a malignancy result. A total of 14 malignancy cases was encountered, and nine of them was adenocarcinoma, four were signet cell carcinoma and one case was MALT lymphoma. 78% of the malignant cases were encountered at the proximal site of the incisura angularis, and in 64% of these malignant cases nodular lesions around the ulcer were encountered. The four ulcers out of eight which were settled at the smaller curvature site were malignant, and only one ulcer at cardia was also malignant. The main method for the discrimination of malign-benign ulcer is still biopsy. The follow up of the patients with repeated multiple biopsies may increase the sensitivity for diagnosis of malignancies in the solitary gastric ulcer.
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PMID:Malignancy risk of gastric ulcers: could it be higher than the expected values? 1524 12

A combination package containing delayed-release capsules of the proton pump inhibitor lansoprazole (15 mg once daily) and tablets of the NSAID naproxen (375 or 500 mg twice daily) has been approved for reducing the risk of NSAID-associated gastric ulcers in NSAID-requiring patients with a documented history of gastric ulcer. In a large, 12-week trial in NSAID (including naproxen)-requiring patients with a documented history of gastric ulcer, significantly more recipients of delayed-release lansoprazole 15 mg once daily than placebo recipients were free from gastric ulcer (p < 0.001). At week 12, the percentages of patients who were free from gastric ulcer were 80% with lansoprazole 15 mg and 51% with placebo. In a subgroup analysis of recipients of naproxen (89% received 750-1000 mg/day), the percentage of patients free from gastric ulcer after 12 weeks of treatment was significantly higher with delayed-release lansoprazole 15 mg than with placebo (89% vs 33%; p < 0.001). In NSAID (including naproxen)-requiring patients with a documented history of gastric ulcer, the incidence of treatment-related adverse events in recipients of delayed-release lansoprazole 15 mg once daily was low (7%), and similar to that in recipients of placebo (10%).
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PMID:Delayed-release lansoprazole plus naproxen. 1532 41

Symptom relief is one of the key goals in the management of gastric acid-related disorders such as gastro-oesophageal reflux disease (GERD), including nonerosive reflux disease (NERD), and duodenal and gastric ulcer. Whereas heartburn and regurgitation are classic symptoms of GERD, duodenal and gastric ulcers are associated with epigastric pain. The relationship between gastric acid and the presence of symptoms correlates well in GERD and duodenal ulcer, but not in gastric ulcer and NERD. Nevertheless, in all these disorders, gastric acid is considered a key pathogenic element, and acid suppression remains central to therapy. With their profound, prolonged effect on acid inhibition, proton pump inhibitors are considered the first-choice therapy for these disorders. Rabeprazole is a newer generation proton pump inhibitor that suppresses the gastric proton pump and acid secretion more rapidly than does omeprazole, lansoprazole or pantoprazole. In clinical trial settings, rabeprazole provided fast and sustained symptom relief, which can help ensure patient acceptance of therapy and aid in patient compliance.
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PMID:Review article: relief of symptoms in gastric acid-related diseases--correlation with acid suppression in rabeprazole treatment. 1549 15


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