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Query: UMLS:C0038358 (gastric ulcer)
5,179 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Parietal cell vagotomy has been in clinical use for 7 years in elective treatment of nonobstructive duodenal ulcer, and for even a shorter period for complicated cases and for gastric ulcer The evolution of the surgical technique has not yet come to an end and the ability to perform the procedure is still improving. It can therefore be questioned, if this operation is yet ripe for a realistic clinical trial, and the great variation in recurrence rate reported in pilot series as well as in prospective randomized clinical trials points to the possibility that we will have to wait several years before the anticipated mean recurrence rate is known. At present it can be stated that even if gastric emptying is not quite undisturbed, the addition of a drainage procedure in nonobstructive cases is unnecessary. The same may be true in some patients with pyloric obstruction. Furthermore, the mortality rate is very low and the incidence of moderate-to-severe dumping and diarrhea is virtually nil.
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PMID:Parietal cell (highly selective or proximal gastric) vagotomy for peptic ulcer disease. 32 14

Two hundred forty patients with benign gastric ulcer were treated in a controlled clinical trial to assess the effect on healing of cimetidine, antacids, and hospitalization. Inpatients and and outpatients were randomly assigned to one of three treatments: cimetidine plus antacid, cimetidine plus dummy antacid, or placebo tablet plus antacid. In 206 patients who met criteria for analysis, ulcer healing as shown by endoscopy occurred by 12 days in 11 to 26 percent and by 42 days in 58 to 76 percent. There were no significant differences in healing between hospitalized and nonhospitalized patients or between treatment subgroups. Symptomatic response was equivalent in all groups. The median antacid consumption was 328 mEq of in vitro buffering capacity per day. Patients taking antacids experienced significant diarrhea compared with those taking no antacid. This investigation suggests that the effect of cimetidine is equivalent to that of large amounts of antacid, but because a true placebo group was not studied it is not possible to conclude from this study alone whether either agent influenced healing. In contrast to widespread belief, initiation of treatment in the hospital did not enhance healing, but because patients were not randomly assigned to inpatient and outpatient status no final conclusion about the effect of hospitalization on healing can be drawn.
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PMID:Cimetidine, antacid, and hospitalization in the treatment of benign gastric ulcer: a multicenter double blind study. 34 Mar 32

A 46-year-old woman with the CRST variant of scleroderma (calcinosis, Raynaud's phenomenon, sclerodactyly, and telangiectasis) was treated with a diphosphonate (disodium etidronate) in an effort to reduce her dystrophic calcifications or retard their progression. After 18 months of therapy, no improvement in her calcinosis was noted. In addition, she developed bloody diarrhea, epigastric burning, and weight loss during the last two months of Therapy. Upper gastrointestinal series revealed a gastric ulcer. Endoscopy with biopsy proved it to be benign. Gastric ulcerations has been seen in animals given disodium etidronate but only at much higher doses than are currently recommended for humans. Although a cause and effect relationship cannot be established with certainty in this patient, it is suggested since she was not receiving other ulcerogenic drugs chronically. This information may be important to other investigators of disodium etidronate.
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PMID:Appearance of a gastric ulcer during diphosphonate therapy in a woman with CRST syndrome. 41 Nov 74

During the last years bile acids have gained more and more clinical importance. They play a decisive part in intestinal fat resorption. Increased bile acid content in the colon will result in diarrhea. By determination of serum bile acids the liver function can be judged exactly. It seems probable that bile acids take part in the pathogenesis of gastritis gastric ulcer and colonic cancer. By administration of chenodeoxycholic acid and ursodeoxycholic acid dissolution of cholesterol stones within the gall bladder is possible.
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PMID:[Clinical significance of bile acids]. 45 69

This study provides a retrospective comparative analysis of results in 90 women patients who underwent three different elective operations for intractable duodenal ulcer disease. Group I (30 patients) underwent truncal vagotomy/antrectomy (TV + A); group II (30 patients) gastric selective vagotomy/pyloroplasty (GSV + P); and Group III proximal gastric vagotomy (PGV). There were no operative deaths among the 90 patients. No patient after TV + A has developed a recurrent ulcer. Two recurrent ulcers developed after GSV + P, and one gastric ulcer occurred after PGV. Dumping, diarrhea, and reflux gastritis were lower after PGV than with TV + A and GSV + P. Follow-up studies have been from six months to ten years. The clinical results among the three groups of women patients compare favorably with results obtained in a recent prospective randomized study using the identical operative procedures in three groups of men patients operated upon for intractability. There was no statistically significant difference between women and men after similar operative procedures, but the postgastrectomy sequelae were less after PGV in both women and men patients.
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PMID:Results of elective duodenal ulcer surgery in women: comparison of truncal vagotomy and antrectomy, gastric selective vagotomy and pyloroplasty, proximal gastric vagotomy. 64 96

The bile acid binding capacity of various liquid antacids and of colestyramin were compared. Aluminium hydroxide containing antacids showed the highest binding capacity. This seems to be of importance also in therapeutic doses for treatment of chologenic diarrhoea, vagotomy diarrhoea and gastric ulcer.
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PMID:[Binding of antacids to bile acids (author's transl)]. 64 58

Cimetidine is an H2-receptor antagonist that is capable of marked suppression of gastric acid and pepsin secretion. Patients with active duodenal ulcer disease treated with cimetidine show improved rates of healing and symptom relief compared with placebo-treated controls. Peptic ulcer and diarrhea of Zollinger-Ellison syndrome and other acid hypersecretory states respond to cimetidine treatment, as may stress ulcers and steatorrhea of patients with pancreatic insuffficiency who have a suboptimol response to oral pancreatin. Effectiveness with gastric ulcer has been less convincing than with duodenal ulcer. In duodenal ulcer disease, cimetidine need not replace less expensive antacid therapy in most cases and is unlikely to replace definitive surgery for suitable candidates.
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PMID:Cimetidine. H2-receptor blockade in gastrointestinal disease. 67 81

Between 1971 and 1976 selective proximal vagotomy (SPV) was performed in 526 patients with uncomplicated duodenal ulcer and in 37 with gastric ulcer. The operative mortality was 0.18%. The post-operative course was without complication in 90%. One to five years post-operatively 75% of patients with duodenal ulcer were largely without symptoms (Visick I and II), a dumping syndrome was present in 6.5%, diarrhoea in 4.2%, gastric outlet stenosis in 1% and recurrent ulcer in 10.9% of patients who could be re-examined. Recurrent ulcer occurred in eight of 36 patients re-examined after SPV for gastric ulcer. Results of SPV so far have shown it to be a useful alternative to gastric resection in the treatment of duodenal ulcer. But its place in the treatment of gastric ulcer remains undecided.
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PMID:[Results of selective proximal vagotomy for gastroduodenal ulcer (author's transl)]. 75 64

The clinical results of truncal vagotomy and drainage for duodenal ulcer in 500 patients are evaluated by a personal 6-8 year follow up. Pyloroplasty was used unless pyloric stenosis made a gastrojejunostomy necessary. Forty-three patients had recurrence (39 were reoperated) and gastric ulcer was seen in five. The rate of dumping was 24% (severe in 3%) and rate of daily-monthly diarrhoea 40% (severe in 8%). Neither dumping nor diarrhoea was related to histamine-activated gastric acid secretion ten days after vagotomy and insulin-activated acid secretion 3 to 4 years later. Dumping was related to epigastric fullness and diarrhoea. Recurrence was related to histamine-activated secretion before and 10 days after vagotomy and to insulin-activated secretion 10 days and 3-4 days after vagotomy. Minor changes were seen in weight- and laboratory-measurements. Anemia was not related to prophylactic intake of iron. Satisfactory results (Visick I-III) were seen in 80% of the patients. The figure may be increased to 86%, including results of operations for recurrence, gastric ulcer and other diseases occurring after the original vagotomy and drainage; even then, the results seem less satisfactory than those after other operations for duodenal ulcer.
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PMID:Clinical results 6 to 8 years after truncal vagotomy and drainage for duodenal ulcer in 500 patients. 121 Oct 38

The authors present 3 cases which illustrate the wide spectrum of clinical presentations of gastrocolic fistula. These complications include (a) pain, feculent vomiting, and diarrhea; (b) gastrointestinal hemorrhage; and (c) peritonitis. The gastric ulcer is easily detected by a barium meal study although a barium enema may be necessary to show the fistulous communication. The relationship of this condition to steroids and acetylsalicyclic acid is stressed. Two other cases are included to illustrate the development of such a fistula and show the distinguishing features of a gastrocolic fistula due to carcinoma of the colon.
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PMID:Gastrocolic fistula as a complication of benign gastric ulcer. 125 59


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