Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0038358 (gastric ulcer)
 5,179 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Important problems currently under study or requiring investigation for better understanding of the pathophysiology and management are reviewed under three major categories: acute peptic erosions and ulcers, gastric ulcer, and duodenal ulcer. In patients with acute erosions and ulcers, we need to identify patients at risk for major bleeds, to prevent lesions induced by anti-inflammatory, non-steroidal drugs, as well as bleeding from stress ulcers, and to perfect and establish the efficacy of endoscopic methods for coagulation of bleeding ulcers. In patients with gastric ulcers, we need to establish the relative importance of gastric acidity and mucosal resistance to ulcerogenesis, to determine factors that influence healing rates, and to uncover the factors responsible for recurrence. In duodenal ulcer patients, we need to determine the relative importance of post-prandial versus interdigestive secretion, the role of pepsin, and the importance of local defense mechanisms such as bicarbonate and mucus secretion, cellular defense, and blood flow. The mechanisms of failure to heal during treatment need attention. The relation of symptoms and clinical course to healing of ulcer craters should continue to be considered, as well as the long-term course of ulcer disease. The consequences of long-term suppression of acid secretion are a potential hazard, and, finally, the prevention of recurrence remains the major clinical problem in duodenal ulcer.
 ...
PMID:Peptic ulcer--current status. 311 95

In order to investigate whether truncal vagotomy effects on the wound-healing of highly located gastric ulcer or not, the ratio of epithelialization of ulcer, gastric acidity, mucosal blood flow, mucosal PGE2 and labelling index of mucosa after vagotomy were studied by using the mongrel dogs which were prepared highly located penetrated gastric ulcer. Following results were obtained. 1. The ratio of epithelialization of vagotomized dogs at the third week after preparing ulcer showed significant high ratio compared with non-vagotomized dogs. Comparing thoracic truncal vagotomy with abdominal truncal vagotomy, the former was more effective than the latter. 2. Mucosal blood flow and gastric acidity were reduced after vagotomy. 3. Mucosal PGE2 decreased at the first week after vagotomy, however, reduced PGE2 recovered up-to the level with non-vagotomized dogs at the second week after thoracic truncal vagotomy and at the third week after abdominal truncal vagotomy, respectively. 4. Labelling indexes showed significant high counts after vagotomy compared with non-vagotomy. In conclusion, it was suggested that truncal vagotomy would be effective on the wound-healing of ulcer due to the reduction of acid out-put and only a transient decrease of PGE2, however, mucosal blood flow decreased after vagotomy.
 ...
PMID:[Experimental study of truncal vagotomy for healing of highly located gastric ulcer]. 316 29

Among 3,501 individuals receiving endoscopic examination for the upper digestive tract, 41 were found to have esophageal candidiasis including 17 malignancies, 14 immunological disorders, 4 diabetes mellitus, 7 other underlying diseases and 7 apparently healthy subjects. The diagnosis was made either by brushing of the esophagus or by histological examination of the biopsied specimen. Systemic invasion of fungi was observed mainly in patients with malignancy involving the hematopoietic system, and most of them had been treated by corticosteroids, antibiotics or anticancer agents. Although complications associated with esophageal candidiasis are rare, it is emphasized that those patients with malignancy as well as impared immunity should be carefully examined for esophageal candidiasis, in order to prevent the fungi from developing invasive candidiasis. It should be noted that a few cases of gastric ulcer treated by H2 blocker revealed esophageal candidiasis, suggesting that decrease of gastric acidity might be one of the factors involved in this pathological condition.
 ...
PMID:Esophageal candidiasis. 318 63

In recent years a series of publications predominantly from English speaking countries have reported on the colonization of the gastric epithelium with Campylobacter pylori in association with gastritis and ulcer disease. In this prospective study we investigated the distribution of Campylobacter pylori in unselected patients undergoing routine endoscopy at the Department of Gastroenterology of the University of Heidelberg. A total of 175 patients were included in the study. Campylobacter pylori could be demonstrated by microbiological and histological methods in 17% of patients with normal gastric mucosa, in 44% with chronic active gastritis and in 48% with stomach ulcer. In our series only 6/23 patients with duodenal ulcer were Campylobacter pylori positive. Additionally intragastric acidity and concentrations of total bile acids were correlated to the colonization of Campylobacter pylori. Bile acid concentrations were found significantly (p less than 0.001) lower in patients with gastritis when Campylobacter pylori was present. These data suggest an association of Campylobacter pylori with diseases of the stomach also in West Germany and a negative correlation of these organisms to enterogastric bile reflux.
 ...
PMID:Prospective study on the distribution of Campylobacter pylori in unselected patients of an endoscopy unit in West Germany. 323 23

Healing of peptic ulcers with drugs which do not in the least interfere with intragastric acidity has only been described for colloidal bismuth subcitrate (CBS). Healing rates both for duodenal and gastric ulcer are comparable with those obtained with H2-receptor antagonists (HRA). Relapse after CBS healing seems less and delayed compared to HRA-induced healing.
 ...
PMID:Bismuth is better. 324 96

129 patients with peptic ulcer in the acute stage of the disease were studied clinically, roentgenologically, endoscopically and morphologically. The patients were classified into two groups--with or without dyspeptic syndrome. The gastric acidity was examined by the fractionary titration method with pentagastrin as stimulant, Reflux-esophagitis was found in patients with hyperacidity as well as in patients with normal and hypoacidity. The destructive changes in the esophageal epithelium were more frequent in the patients with duodenal ulcer--12.9% than in the patients with gastric ulcer. The reflux-esophagitis was found three times less in the patients with peptic ulcer without dyspeptic syndrome than in the patients with peptic ulcer with dyspeptic syndrome, without reliable differences in the secretory indices between the two groups. The conclusion is made that the gastric acidity without functional disorders in the gastroesophageal segment is not a decisive factor in the development of the dyspeptic syndrome in peptic ulcer.
 ...
PMID:[Secretory gastric function and the development of reflux esophagitis in peptic ulcer]. 324 98

Published clinical trials (N = 56) of antisecretory drugs in the treatment of benign gastric ulcer were reviewed. Composite healing rates for various drug regimens were calculated using a method previously described for duodenal ulcer. Healing rates were compared with data on suppression of intragastric acidity to see if any relationship was evident. No significant correlations between the two existed, unless placebo data were included in the analysis. Correlations were stronger with suppression of total 24-hr rather than nocturnal acidity. Using Williams' method for assessing trends, it was found that an increase in antisecretory effect is not associated with a concomitant increase in healing rates. Duration of medical treatment is the single most important factor in healing of benign gastric ulcer; healing rates for all drug regimens and placebo show a consistent increase with prolongation of treatment.
 ...
PMID:The treatment of gastric ulcer with antisecretory drugs. Relationship of pharmacological effect to healing rates. 328 50

The current therapeutic approach to peptic ulcer disease includes agents that reduce gastric acidity and hence peptic activity, inactivate or adsorb pepsin, create a physical barrier against the effects of acid and pepsin, or enhance mucosal defence. Profound gastric acid reduction may predispose to infection, and it has been suggested that carcinogenesis is possible, although a cause-effect relationship has never been established. The side-effects of therapy are well-described, and may limit the therapeutic approach. Healing rates correlate closely with acid suppression in duodenal ulcer, but not entirely in gastric ulcer. Maintenance therapy lowers the relapse rate, but does not alter the ulcer diathesis. The optimal strategy for long-term management remains unclear, but in the future one should consider outcome measures which include a decrease in pain, improvement in the quality of life, reduction work loss, and a reduction of complications, in addition to ulcer healing. The ideal therapy should be efficacious, safe, and convenient--with no side-effects--and cost-effective. New agents should suppress acid and peptic activity, while enhancing the gastric mucosal defence mechanisms (such as mucosal blood flow, mucus, and bicarbonate secretion) and stimulating gastric cellular regeneration and restitution.
 ...
PMID:The limitations of current therapy in peptic ulcer disease. 330 47

Pain is commonly the initial symptom in peptic ulcer, but the mechanism is controversial. Chemical irritation by hydrochloric acid (HCl) and disordered motor activity have been implicated. Questions have been raised as to whether pain is a good indicator of an active ulcer. We have studied the mechanism of ulcer pain, using intragastric administration of 0.1 N HCl, study of X-ray alterations, measurement of intraluminal pressures, and measurement of gastric acidity along with fluorocinematography. Ulcer pain was accompanied by a synchronous increase in motor activity; gastric emptying was rapid with duodenal ulcer and delayed with gastric ulcer; relief of pain occurred with emptying. Ulcer pain is not a good indicator of activity. Relief of ulcer pain before endoscopic healing with famotidine is due to the inhibition of HCl below the threshold required to initiate disturbances of motor activity. Recurrent 'silent' ulcer with complications occurs in 40% of patients.
 ...
PMID:Ulcer pain mechanisms. The clinical features of active peptic ulcer disease and implications for therapy. 331 Jan 99

Ulcer formation after pylorus ligation was assessed in control, testosterone treated and castrated male rats after cimetidine treatment. The stomach was studied for incidence of ulcers and its contents analysed for pH, volume, total acidity, free acidity, pepsin and mucin activity. Testosterone and cimetidine when used alone protected from ulceration while when used in combination the degree of protection was decreased. Castration per se ead no effect on ulcer index but potentiated cimetidine induced gastric ulcer protection.
 ...
PMID:Relevance of male hormonal status with antiulcer effect of cimetidine in pylorus ligated rats. 345 Jun 32


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>