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)

Six-hundred sixty-seven patients with endoscopically proven peptic ulcer were included in a randomized, multicenter trial to assess the comparative efficacy of sucralfate and cimetidine. One hundred eighty-seven patients with gastric ulcer and 480 patients with duodenal ulcer completed the study. Ulcer healing was evaluated endoscopically at six weeks for duodenal ulcer and at eight weeks for gastric ulcer. Patients with unhealed ulcer at this time were assigned to the other therapy for a second period of six or eight weeks of treatment (crossover). In patients with duodenal gastric ulcer, pain relief and healing were not significantly different in the two groups. Eighty-eight percent of duodenal ulcers and 73 percent of gastric ulcers healed with six weeks of sucralfate treatment. Reported side effects and symptoms, pooled together for duodenal and gastric ulcer, were more significant in the sucralfate group (7.5 percent) than in the cimetidine group (3.7 percent). Constipation was the most frequent symptom recorded. In conclusion, sucralfate and cimetidine are both excellent healing agents for short-term treatment of duodenal and gastric ulcer. Both give rapid relief of symptoms without severe side effects.
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PMID:Comparative study of sucralfate versus cimetidine in the treatment of acute gastroduodenal ulcer. Randomized trial with 667 patients. 266 May 53

Forty-nine Chinese patients, ages 65 years or over, with endoscopically and pathologically diagnosed benign gastric ulcer, completed a randomized double-blind double dummy trial in treatment with either cetraxate 200 mg four times daily or ranitidine 150 mg two times daily for 12 weeks or less if the gastric ulcer had completely healed. All patients tolerated the procedure well. At the end of the 4th, 8th, and 12th weeks ulcer healing was complete in 2 (8%), 11 (42%), and 17 (65%), respectively, of the cetraxate group (26 patients); and in 8 (35%), 18 (78%), and 22 (96%), respectively, of the ranitidine group (23 patients). All the differences in the healing rates were statistically significant. Pain relief was significantly earlier with ranitidine. Incidences of side effects were similar and not serious in the two groups. The results suggest that at the doses prescribed to the elderly, ranitidine is significantly more effective than cetraxate in gastric ulcer healing and pain relief.
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PMID:Healing of gastric ulcer in the elderly: a double-blind study of cetraxate versus ranitidine. 266 58

Dysfunction of the sphincter of Oddi (SOD) is an uncommon condition which must be considered in cases of persistent pain in the upper abdomen following uncomplicated cholecystectomy, when disease in other organs, such as gastric ulcer, esophagitis and pancreatitis has been eliminated. The pathogenesis is not fully elucidated, but it is assumed that the cholecystectomy in some cases induces an increased tendency to spasm in the sphincter of Oddi (SO), and, perhaps in connection with an increased sensitivity to pressure elevations in the biliary tree, results in attacks of pain. Whether fibrosis (stenosis) of the SO due to instrumentation or passage of stones is part of the etiology is obscure. Endoscopic retrograde cholangiopancreaticography with papillary manometry should be performed in all cases where SOD is suspected. An elevated basal pressure in SO seems to be the best indicator of SOD. In cases unresponsive to conservative treatment, endoscopic sphincterotomy may be considered. This treatment is not finally evaluated, but apparently the effect is good, especially in patients with elevated basal pressure in SO. It is emphasized that the knowledge of the behavior and regulation of SO is incomplete and that this should be remembered when criteria for SOD are applied.
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PMID:[Oddi's sphincter dysfunction]. 267 55

In a double-blind study of 163 patients with benign chronic gastric ulcer, 83 were randomly assigned to receive 800 mg of cimetidine once daily at bedtime for six weeks and 80 received placebo. After six weeks of treatment, the ulcers were healed in 76% of the cimetidine-treated patients and in 55% of the placebo group (P less than 0.003). Within two weeks of starting cimetidine treatment, over 60% of the patients were without daytime or nighttime pain. At six weeks. 77% of the cimetidine-treated patients and 67% of the placebo group were without daytime pain and 89% and 74% (P less than 0.05), respectively, were without nighttime pain. The proportion of pain-free nights and days increased each week in the cimetidine-treated patients. Transient and self-limited adverse experiences were reported by 13% of the cimetidine-treated patients and by 15% of the placebo group. The results achieved in the present study with a once-daily, bedtime dose of cimetidine are similar to those seen in patients given cimetidine twice and four times daily.
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PMID:Once-daily bedtime dosing regimen of cimetidine in the treatment of gastric ulcer. 268 85

In a randomised, double blind, parallel group study in patients with symptomatic gastric ulcer (94% greater than or equal to 5 mm diameter), 102 received omeprazole 20 mg om and 87 cimetidine 400 mg bd. After four weeks 73% and 58% (p less than 0.05) respectively had healed (eight weeks: 84% and 75%, ns). After four weeks, a greater proportion (81%) of omeprazole treated patients was symptom free than of those receiving cimetidine (60%; p less than 0.01). Over the first two weeks, patients receiving omeprazole had less day pain, less night pain and took fewer antacids than those receiving cimetidine (all p less than 0.05). The difference between omeprazole and cimetidine was not appreciably affected by age, smoking, size of the ulcer and trial centre. Tolerability was similar in the two treatment groups. In the treatment of symptomatic gastric ulcer, omeprazole relieves the symptoms more quickly than cimetidine and heals a greater proportion of ulcers within four weeks.
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PMID:Randomised, double blind comparison of omeprazole and cimetidine in the treatment of symptomatic gastric ulcer. 233 80

Antisecretory drugs are known to be valuable in the treatment of gastric ulcer. Recent studies have shown that this also holds true for omeprazole, the most effective antisecretory drugs currently available. At 30-40 mg once daily omeprazole provides cumulative healing rates of up to 100% after 4-8 weeks. In one study, omeprazole, 20 mg, and ranitidine, 150 mg b.d., produced similar healing rates in the acute treatment of gastric ulcer, though there was a tendency towards more rapid healing with omeprazole. In a more recent multicentre study including more than 600 patients, significantly more ulcers healed after 4 weeks with omeprazole, both 20 mg and 40 mg once daily, than with ranitidine, 150 mg b.d. Omeprazole was also superior to ranitidine with respect to relief of night-time pain and in gastric ulcer healing during concomitant therapy with non-steroidal anti-inflammatory drugs. After omeprazole therapy, the proportion of patients in remission during the following half-year period was higher than after ranitidine, arguing against the hypothesis that rapid ulcer healing following more effective inhibition of acid secretion might be of lower quality. During acute therapy, no drug-specific serious side-effects occurred. Omeprazole is a valuable alternative in modern treatment of gastric ulcer, being superior to histamine H2-receptor antagonists.
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PMID:Omeprazole in the acute treatment of gastric ulcer. 269 Mar 33

In duodenal ulcer studies comprising more than 2,000 patients the efficacy of omeprazole in doses of 20-40 mg once daily has been compared with the recommended doses of the H2-receptor antagonists cimetidine and ranitidine. At 2 weeks the differences in healing rates in favour of omeprazole were 12-33%; while they were somewhat lower at 4 weeks, ranging from 4 to 20%. In most studies the difference in healing rate was statistically significant. In some studies pain relief at 2 weeks was more pronounced on omeprazole. In three gastric ulcer studies omeprazole in doses of 20 or 40 mg once daily has been compared with ranitidine 150 mg twice daily. Healing rates on omeprazole were significantly greater in 2 of the 3 studies. Pain relief was faster on the higher dose of omeprazole. In prepyloric gastric ulcer the healing rate at 2 weeks was not significantly greater on 20 or 40 mg omeprazole than on ranitidine, while in another study the healing rate was significantly greater on 30 mg omeprazole as compared with cimetidine. In the first week of treatment more patients on omeprazole became free of pain in the latter study. The relapse rate after stopping therapy was similar for omeprazole and the H2-receptor antagonists independent of the type of ulcer. In conclusion, omeprazole heals ulcers faster than the recommended doses of H2-receptor antagonist. The difference in healing rate is more pronounced halfway than at the end of the treatment course.
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PMID:Efficacy of the H+/K+-adenosine triphosphatase inhibitor omeprazole in peptic ulcer. 269 8

Factors influencing the healing rate were evaluated by multivariate analysis on 148 patients with gastric ulcer who were under treatment with cimetidine at a daily dose of 800 mg. Factors used were age, sex, therapeutic environment, duration of present ulcer pain, past history of gastric ulcer, the amount of tobacco, alcohol, and coffee consumed before and during the treatment, the period until symptoms disappeared after the commencement of the treatment, and the characteristics of the ulcers themselves. Of these factors, the five factors that had a significant delaying effect on the healing of gastric ulcers were: 1) having a past history of gastric ulcers, 2) symptoms not disappearing within 1 wk after the commencement of the treatment, 3) size over 20 mm, 4) ulcer located in an angle, and 5) round or oval shape of the ulcer. The patients with less than one of the unfavorable factors (n = 36) had the best healing rate (97.2%), compared with those with two (n = 61), three (n = 39), or four or more (n = 12) unfavorable factors. The healing rate of the latter three groups was 75.4%, 53.8%, and 33.3%, respectively (p less than 0.01). Thus, a prognostic score based on these five factors represents the severity of gastric ulcers with regard to the healing in patients prescribed cimetidine.
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PMID:Factors influencing the healing rate of gastric ulcer under treatment with cimetidine. 271 6

20 patients with peptic gastric ulcer and 30 patients with peptic duodenal ulcer were treated with Milid (Proglumid). The following results were achieved: in 85% of the patients with peptic gastric ulcer and in 93% of the patients with duodenal ulcer the pain was relieved on the 4th day on the average. In 95-96% of the patients treated the dyspeptic complaints disappeared on the 2-3 day. The endoscopic examination performed on the 20th day revealed full epithelization of the ulcer in 30% of the patients with gastric ulcer and in 43.3% of the patients with duodenal ulcer. Following the treatment course the basic secretion and acid production fell statistically significantly in the patients with gastric ulcer while in the patients with duodenal ulcer the basic and stimulated secretion and acid production were suppressed. The drug Milid does not change the serum gastrin level but suppresses the gastrin secretion in the gastric juice. The Milid treatment leads to an increase of the quantity of the N-acetylneuraminic acid in the gastric juice which partly reflects the cytoprotective action of Milid. The drug can be used in the everyday practice for the treatment of peptic ulcer.
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PMID:[Treatment of peptic ulcer using proglumide (Milid)]. 274 40

Of 333 duodenal ulcer (DU) patients 75 (22.5%) were aged 65-93 years (study group). Ninety-two percent (306 patients) of the entire group were diagnosed endoscopically, and all were followed prospectively. In the study group of the older patients there were fewer smokers, but more patients used steroids and other nonsteroidal antiinflammatory drugs (NSAIDs) and had more arteriosclerotic heart disease than the younger control group. Presenting signs and symptoms were similar in both age groups, although painless upper gastrointestinal bleeding was more common in the elderly, and pain, when present, tended to be milder. Bleeding episodes were more prevalent in the older age group. Another difference between the groups was the larger incidence of concurrent gastric ulcer and DU observed endoscopically in the study population. Steroids and NSAIDs could be etiologically connected to bleeding in the older patients, as well as to their relative lack of pain. We conclude that DU in the elderly tended to present atypically and that pain was not the major symptom of activity. This places a different emphasis on diagnostic and therapeutic criteria.
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PMID:Duodenal ulcer in the elderly. 279 28


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