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)

Dyspepsia may result from over-indulgence in alcohol and food, or from anxiety and emotional problems. It may also indicate a peptic ulcer, oesophagitis or less commonly, gallstones or gastric cancer. Investigation by endoscopy or barium studies is always indicated when an organic lesion is suspected. Reassurance, tranquillizers and antispasmodics help patients with functional dyspepsia. Antacids given hourly between meals are important in the treatment of all symptomatic peptic ulcers. Cimetidine causes rapid symptomatic relief of duodenal ulcer symptoms, and most ulcers will heal with six weeks' therapy. Gastric ulcer can be treated with carbenoxolone, but this drug is avoided in the elderly and in patients with cardiac failure or hypertension. Anticholinergic drugs are of value in duodenal ulcer, especially for night pain, but they should not be used in patients over the age of 50. Special diets are of no value. For the heartburn of oesophagitis, weight reduction and a regime of regular antacid therapy remain the important measures.
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PMID:The treatment of dyspepsia. 92 13

The prevalence of Campylobacter pylori infection as detected by histology was studied in 5 predefined groups of patients. The associated histologic and endoscopic findings were registered. Validity of CLO-test was tested against the histologic detection. The following groups of patients were studied: A) Non-ulcer dyspepsia (defined by one or all of three symptoms: heartburn, nausea/inappetence, halitosis/belching) B) control group (no specific symptoms, no ulcer, no history of gastric surgery) C) Duodenal ulcer D) Gastric ulcer E) Billroth I or II resection of the stomach. 200 patients were recruited for group A-C, in group D 134 patients and in group E 113 patients were studied. A mean prevalence of 60% was observed. Prevalence was highest in patients with duodenal ulcer (86%). In group D a prevalence of 65%, in A and E a prevalence of 54%, and in B of 40% were seen. The overall test sensitivity of the CLO-test compared against the histologic detection rate was 75%, the specificity 81%. Sensitivity was reduced in group A (69%) and E (53%) and in patients with inactive chronic gastritis (67%). In all groups patients with active forms of gastritis showed the highest prevalence of C. pylori infection. The specificity of the CLO-test was reduced in patients with duodenal ulcer (46%) and gastric ulcer (48%). Decreased specificity observed after therapy with histamin receptor (H2) blockers may explain this finding. The relationship of C. pylori infection with active types of gastritis or gastro-duodenal ulcer hints at a causal relation but is no definite proof of its etiologic role. The validity of the CLO-test seems questionable in patients with gastroduodenal ulcer or operated stomach.
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PMID:Prevalence of Campylobacter pylori as demonstrated by histology or CLO-test in different types of gastritis. A study in 5 clinically predefined groups of patients. 196 52

This study was based upon deceased patients in a geriatric university hospital with a high autopsy rate (81%). Of 6200 autopsied patients, 333 (5.4%) had had an active peptic ulcer; agonal and other acute erosions were not included. 257 cases were selected for the study (average age 83.8 yr). The diagnostic accuracy, and the symptoms of peptic ulcer in stationary, elderly, chronically ill patients were studied retrospectively. Only 16% of cases with duodenal ulcer and 29% with gastric ulcer had been correctly diagnosed antemortem. The clinical features of ulcer disease in the elderly may often differ from the standard presentation in younger people. Prior to death, appetite and weight loss, nausea/vomiting, anaemia and positive occult blood test had been more common among patients with ulcer, than abdominal pain and heartburn. The predictive values of single symptoms and of combined findings were low (range 2-21%), thus supporting observations from clinical practice that diagnosis is difficult in geriatric medicine. Prospective studies of ulcer disease in living elderly are needed.
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PMID:Peptic ulcer in geriatric long-term care medicine. 248 4

A non-comparative multicentre study of 78 patients with healed gastric ulcers who had received roxatidine acetate was conducted to determine the ulcer recurrence rates during 6 months' maintenance therapy with roxatidine acetate 75 mg at night. Gastric ulcer relapses occurred in 35% of patients, representing a worst possible outcome estimate, with no significant differences between smokers and non-smokers although heavy smoking appeared to increase the rate of relapse. The incidence of epigastric pain did not significantly increase over the duration of therapy and while some patients complained of mild pain at the start of the trial all subjects had endoscopically confirmed healed ulcers. The consumption of antacids for symptom relief was low, reaching an average of 0.75 tablets a day which was insufficient to influence intragastric pH. Continuous poor appetite and pyrosis were reported by about 5% of subjects. Of 2 patients who complained of mild to moderate side effects, 1 discontinued treatment. In addition, there were no clinically significant changes in haematological and biochemical variables. Thus, maintenance therapy with roxatidine acetate 75 mg at night is safe and generally effective in preventing symptomatic relapse.
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PMID:Roxatidine acetate in the long term maintenance of gastric ulcers. 290 42

Analysis of clinical data obtained in a double-blind randomized study, which compared liquid antacid (neutralizing capacity 120 mmol per day) with 1 g cimetidine in the treatment of 125 patients with gastric ulcer, revealed that, before starting treatment, 71% of the patients complained of epigastric pain, approximately 50% of bloating, and approximately 30% of nausea, heartburn, constipation or vomiting. Epigastric pain before treatment was significantly more frequent in patients with large ulcers (P less than 0.05) and in patients with ulcers unhealed after 4 weeks of therapy (P less than 0.05). This finding was the result of a highly significant correlation between diurnal epigastric pain and ulcer size and delayed healing (P less than 0.005). Nocturnal pain did not correlate with prognosis. In contrast to this correlation between pain before therapy and healing, the disappearance of epigastric pain with therapy did not signify ulcer healing. Only 14 (38%) of the 37 patients with healed ulcer were free from pain after the 4 weeks of therapy, whereas 25 (49%) of the 52 patients with persistent ulcers had no pain at this time. Placebo pain tablets relieved ulcer pain effectively in more than 85% of the patients, irrespective of whether the ulcer was healing or not. The other symptoms (bloating, nausea, heartburn, constipation or vomiting) were also alleviated by 4 weeks of therapy but no correlation was found with ulcer size or prognosis. The loss of the prognostic significance of ulcer pain is probably due to a complex interaction of the trial schedule on the patient's level of consciousness.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Loss of predictive value of gastric ulcer symptoms in a randomized treatment trial. 297 76

Two parallel groups, each of 10 out-patients with endoscopically confirmed benign gastric ulcer, were randomly assigned to receive either 1.5 g/day of triletide, a new tripeptide shown to increase the synthesis of gastroduodenal mucus and to antagonize thromboxane A2, or 0.3 g/day of carbenoxolone. Both drugs were given orally in 3 divided doses for 4 weeks, according to the controlled design. Endoscopy showed that a greater proportion of patients treated with triletide benefited from treatment (60%) in comparison with those who had carbenoxolone (40%), but the difference was not significant. Weekly monitoring of epigastric pain, heartburn and antacid intake showed both treatments to be effective, and triletide to be overall faster acting (p less than 0.01 for epigastric pain). Subjective complaints of possible side-reactions were not recorded with either treatment; routine physical examination, haematology and haematochemistry remained unaffected by triletide, whereas treatment with carbenoxolone was associated with a significant increase in both systolic and diastolic blood pressure and with a significant decrease (p less than 0.05) in blood potassium levels. Triletide, therefore, appeared to be an effective and well-tolerated means for the therapy of gastric ulcer, and by virtue of its significantly greater symptomatic action and greater tolerance in comparison with a standard cytoprotective treatment such as carbenoxolone, it is suggested that triletide deserves consideration in the management of peptic ulcer.
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PMID:Cytoprotective therapy of gastric ulcers: a controlled clinical evaluation of triletide versus carbenoxolone. 390 85

The results from Alcid V treatment are reported, carried out in the course of 20 days on 39 patients with duodenal and 20 patients with gastric ulcers. A group of 20 patients with duodenal and 10 with gastric ulcers, treated with placebo served as a control under the conditions of double-blind experiment. The pains completely abated in 84 per cent of the patients with gastric ulcer, the pyrosis in 100 per cent, eructation--in 92.3 per cent and the ulcer--in 68.42 per cent, and in the patients with duodenal ulcers--76.9 per cent, 93.10 per cent, 94.3 per cent and 40.62 per cent respectively. As regards the clinical symptoms of gastric ulcers, very good effect was obtained in 76 per cent and good effect--in 24 per cent; in the cases with duodenal ulcers--70.49 per cent and 15.38 per cent respectively. The discrepancy between the effect on the clinical symptoms and on the ulcers (the changes of the latter being endoscopically determined) between the Alcid V treated patients and the control group with placebo are statistically significant. In both groups the gastric secretion (determined by pentagastrin test) is not substantially changed as compared with the values prior to the treatment. Alcid V in the dose administered and the duration of the treatment induced no adverse effects and no essential changes in the biochemical indices; it was well tolerated and could find its application in the treatment of ulcer disease.
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PMID:[Treatment of peptic ulcer with Alcid V]. 635 4

A prospective controlled trial of proximal gastric vagotomy (PGV) in 829 patients at three surgical services is presented. Peroperative tests of vagotomy completeness were made in two of the three groups of patients. The follow-up period was four to six years. The hospital stay after PGV averaged 9.2 days. The postoperative mortality rate was 0.2%. The reduction of gastric acidity was maintained four years after PGV. Postoperatively no patient had severe diarrhoea. The incidence of dumping after PGV was 1.5% and of gastric stasis 7.3%. Though 7% of the patients reported pyrosis after PGV, only a few required treatment. Transient dysphagia was reported by 2.5% of the patients. In about 4% of the series there were relatively mild ulcer-like symptoms postoperatively, without confirmation of ulcer. Duodenal ulcer recurred in 2% of cases during the observation period and gastric ulcer appeared in 1.5%. According to the Visick classification, 74% of the series showed grade I clinical result, 18% grade II, 4% grade III and 4% grade IV. There were no intergroup differences in Visick grades.
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PMID:Proximal gastric vagotomy. A prospective study of 829 patients with four-year follow-up. 683 26

The patient was a 79-year-old man who underwent extensive gastrectomy and Billroth-II reconstruction for gastric ulcer in 1974. He complained of heartburn in November, 1992, and endoscopy for the residual stomach revealed IIb + IIa-like lesion mainly in the posterior wall of the anastomosed site, which was diagnosed as well differentiated adenocarcinoma. As the patient refused to be operated, 150 mg/day of 5-FU was administered. For 4 months before he decided to undergo operation, 12.9 g of 5-FU was administered in total. After rehospitalization, endoscopy of the residual stomach showed shrinkage of the lesion, and biopsy revealed no malignant findings. The pathological examination after total resection of the residual stomach showed atypism, but no evidence to support malignancy. He has continued to be well without sign of recurrence for 1 year since the operation. The administration of 5-FU is widely used as preoperative adjuvant chemotherapy. This case it is rare for 5-FU to cause the disappearance or falling off of malignant cells.
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PMID:[Effects of 5-fluorouracil in shrinking residual gastric cancer: a case report]. 779 3

The frequency of pyrosis and its correlation with hyperregeneratory oesophagopaty in patients with duodenal and gastric ulcer and normal oesophago-gastric junction has been investigated. The normal oesophago-gastric junction has been evaluated by endoscopy. The frequency of pyrosis was significant in the group of patients with duodenal ulcer, and the hyperregeneratory oesophagopaty has been more frequent in this group.
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PMID:[Pyrosis in gastric and duodenal ulcer disease and endoscopic verification of sufficient closing of the esophagogastric junction]. 793 21


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