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

Predictable factors in healing of 48 patients with gastric ulcer by PPI or H2-RA on 4 and 8 weeks of treatment were investigated. We evaluated the following factors such as patient's profile, local morphologic factors of gastric ulcer and suppression rate of 24 hr intragastric pH between healed and unhealed patients using single and multiple variable analysis. Results obtained from multiple variable analysis, the significant and independent factors of intractable gastric ulcers on the 4th week of treatment were ulcer size in over 20 mm and solitary ulcer. On the contrary, those of 8th week of treatment were shortage of holding time of intragastric pH over pH4 (less than 16.7 hrs) during treatment, the site of ulcer at lesser curvature of gastric angle and the shape of ulceration which showed mucosal overhanging. Considering with single and multiple variable analysis, we concluded that, in early phase, local shapes of the ulceration were important predictors in the healing of gastric ulcer, and the after that, the inhibition of intragastric acidity were significant factors in healing process of gastric ulcer.
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PMID:[Predictable factors in healing of gastric ulcer, comparative analysis of local morphologic factor of gastric ulcer and suppression of intragastric pH]. 773 28

The incidence of postoperative wound infections is increased up to 35% after gastroduodenal surgery, when gastric motility and acidity are decreased, as in case of gastric ulcer or cancer, obstruction, bleeding, antacid therapy. The endogenous flora contaminating the operative-site consists of organisms of the oropharynx and the jejunum and includes anaerobes like bacteroides, aerobes like streptococci, staphylococci, E. coli. Antimicrobial prophylaxis is therefore indicated in these high risk patients. All groups of antibiotics have been used, however 1st and 2nd generation cephalosporins are the most effective. A single dose given intravenously just before anaesthesia is recommended, a second dose is advisable intraoperatively when surgery is prolonged or massive blood loss occurs. Antibiotic prophylaxis is also recommended in gastric bypass surgery for obesity, but remains controversial for percutaneous endoscopic gastrotomy.
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PMID:[Antibiotic prophylaxis in gastroduodenal surgery]. 777 99

Gastric acid is of central importance in the pathogenesis of duodenal ulcer, gastric ulcer, and gastroesophageal reflux disease. Pharmacological reduction of acid secretion is, therefore, the mainstay of current treatment, but the optimal degree of acid suppression remains incompletely understood. This paper considers the ideal ways of assessing and reporting the pharmacological effectiveness of acid-inhibiting drugs and relating such data to clinical efficacy. Twenty-four-hour intragastric pH measurements are widely used for this purpose, although this technique cannot measure secretion quantitatively. Data on suppression of 24-hr intragastric acidity for groups of subjects have been successfully correlated with healing rates for duodenal ulcer, gastric ulcer, and gastroesophageal reflux disease. Three primary determinants of healing have been derived from antisecretory data. These are the degree of suppression of acidity, the duration of suppression of acidity, and the duration of treatment. The order of importance of these determinants varies depending on the disease. Data on 24-hr intragastric acidity should be accompanied whenever possible by data on 24-hr plasma gastrin levels, as the relationship between suppression of acidity and a rise in gastrin varies widely between individuals. It is not possible to predict the plasma gastrin level from the intragastric pH or any other measurement of intragastric acidity. Comparative data sets in groups of subjects may provide useful information. Proton pump inhibitors produce a greater and longer-lasting degree of suppression of acidity than conventional doses of H2-receptor antagonists. For this reason, they are more effective in healing duodenal ulcer and gastric ulcer. However, in view of the importance of duration of treatment, healing rates with the H2-receptor antagonists approach those obtained with proton pump inhibitors if treatment is continued for a longer time. In gastroesophageal reflux disease in particular, although the optimal degree of acid suppression is not yet defined, the consistently superior performance of proton pump inhibitors demonstrates that increased suppression of acidity is clinically beneficial.
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PMID:Optimizing acid suppression for treatment of acid-related diseases. 785 82

The Os Sepiella maiudrone (OSM) could markedly inhibit the stress-induced gastric mucosal lesions and promote the healing of acetic acid-induced gastric ulcer in rats were reported previously. In order to demonstrate its mechanism, the effects of OSM on acidity of gastric juice, combined mucus content in gastric wall, DNA synthesis, gastric movements, the gastric contents of prostaglandin E2 (PGE2) and cAMP of gastric tissue were examined. The results showed that OSM could neutralize the gastric acid, promote the production of cAMP and PGE2 in gastric tissue. These suggested that the neutralization of gastric acid and enhancing the gastric mucosal cytoprotection by OSM would play a role in preventing and curing gastric ulcers in rats.
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PMID:[A study on Mechanism of prevention and treatment of gastric ulcer with Os sepiella in rats]. 804 5

The relationship between the inhibition of intragastric acidity and healing has been determined for both duodenal and gastric ulcers, with a stronger correlation being evident in duodenal ulcer. Omeprazole is clearly more effective than H2-receptor antagonists in healing duodenal ulcers and in the resolution of attendant symptoms. As the recommended treatment periods are shorter with omeprazole (e.g. 2-4 weeks) than with H2-receptor antagonists (4-8 weeks), omeprazole has also been shown to be more cost-effective. Long-term management strategies for peptic ulcer are evolving rapidly in the light of evidence that Helicobacter pylori eradication reduces or eliminates ulcer relapse. Regimens, such as omeprazole in combination with amoxycillin or clarithromycin, that both eradicate H. pylori and heal ulcers rapidly are appealing because they are simple, well tolerated, convenient and efficient in both healing ulcers and preventing relapse. This comprehensive approach appears to be evolving as the dominant strategy for the future treatment of peptic ulcer diseases. Gastric ulcer disease is also treated more effectively with omeprazole than with H2-receptor antagonists, both in terms of speed and reliability of healing, and in terms of symptom resolution. At 4 weeks, symptom resolution has been specifically examined in six comparative trials; in three of these, omeprazole was superior to the H2-receptor antagonist, and in the other three was at least as good as the H2-receptor antagonist. Omeprazole, 40 mg once daily, effectively heals non-steroidal anti-inflammatory drug (NSAID)-induced ulcers in about 90% of cases, even if NSAID therapy is continued, and is probably the treatment of choice for patients with ulcers requiring continued NSAID therapy.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Emerging strategies for managing peptic ulcer disease. 804 24

The 24-hour intragastric pH monitoring was conducted in patients with gastric ulcers treated with an H2 blocker, and the pathophysiological conditions and the treatment of intractable gastric ulcers were studied from the aspect of degree of intragastric acidity. During the administration of a standard dose of an H2 blocker, there was no difference of intragastric acidity at night between intractable gastric ulcers and tractable gastric ulcers. However, intragastric acidity was significantly higher during the day in the intractable gastric ulcers. The pH 3 holding time rate during the day in all intractable gastric ulcer patients was less than 45%; however, in the tractable gastric ulcer patients it was more than 45% during the day. In treating intractable gastric ulcers, if combined administration of synthetic prostaglandin E2 having a suppressing action of gastric acid secretion was performed or if the drug was changed to a proton pump inhibitor, a rise in intragastric pH was observed and earlier cure was obtained. That is to say, intractable gastric ulcers are characterized by inadequate suppression of gastric acid during the day, and it is surmised that if gastric acid can be adequately suppressed not only during the night but also during the day, no matter which drug or administration method is used, it will be effective against intractable gastric ulcers.
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PMID:[A clinical study of pathophysiology and treatment of intractable gastric ulcers based on 24-hour intragastric pH monitoring]. 809 80

The effects of single morning and single bedtime doses of famotidine on intragastric acidity were studied by 24-h intragastric pH monitoring in 16 patients with gastric ulcer. The patients were randomly allocated to the following regimen: one group (n = 8) received 40 mg famotidine at 8:30 AM and another group (n = 8) received the same dose at 10 PM. The morning group showed significant inhibition of gastric acidity during the 24-h and daytime measurements, compared to those of the bedtime group (p < 0.05 in 24 h, p < 0.01 in daytime). Conversely, the bedtime group showed a significant inhibition of gastric acidity during the nocturnal period compared to the morning group (p < 0.01). These results indicate that the relative importance of suppression of gastric acidity on the gastric ulcer healing process should be evaluated in a clinical trial.
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PMID:Comparison of the effects of single morning and single bedtime doses of famotidine on intragastric acidity in patients with gastric ulcer. 794 55

The anti-ulcer effects of a natural mixture of higher aliphatic primary alcohols, designated D-002, isolated from beeswax, were compared with those of cimetidine on indomethacin-, ethanol-, water-immersion-induced ulcers and on gastric secretion in rats. D-002 (25-50 mg kg-1 p.o.) was similar to cimetidine in dose-dependently reducing the duration of indomethacin-induced ulcers while also being effective in preventing ethanol-induced ulcers, which are not affected by cimetidine. On the other hand, D-002 (100 mg kg-1) moderately decreased the volume of gastric basal secretion in pylorus-ligated rats, but not the acidity. Nevertheless, it inhibited gastric ulcer induced by pylorus-ligation at doses (50 mg kg-1) that were ineffective in decreasing the volume. In addition, 100 mg kg-1 of D-002 prevented the formation of acute gastric ulcers induced in rats by water-immersion stress. The results demonstrate the anti-ulcer activity of the preparation in different experimental models suggesting its potential value for ulcer therapy.
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PMID:Anti-ulcer activity of higher primary alcohols of beeswax. 858 84

This study was undertaken to assess postoperative gastric motility and gastric acid secretion, and pre- and postoperative carbohydrate metabolism in patients with esophageal cancer. The gastric motility was compared among 3 different reconstruction routes in 26 patients who were divided into 2 groups according to the duration of postoperative follow-up; group A, 3 months or less; and group B, 18 months or more. The routes used for subtotal resection of the stomach were the posterior mediastinal, retrosternal, and subcutaneous routes. All patients showed positive resting pressure in the esophagus, but peristaltic waves did not reach the gastric tube at dry swallowing in any patients and peristaltic waves appeared after eating pudding only in 1 patient in group B. The resting pressure and gastric emptying time were similar among reconstruction routes, but the incidence and amplitude of metoclopramide (MCP)-induced peristaltic waves were significantly higher in group B than in group A. Furthermore, 24-h intragastric pH monitoring of gastric secretion in a group of 9 patients revealed individual variation in gastric secretion. Some patients showed high acidity soon after operation, suggesting the need for prophylactic treatment for preventing gastric ulcer. Postoperatively, postprandial serum gastrin levels were significantly higher than preoperative levels. In the other group of 11 patients tested, preoperative and postoperative carbohydrate metabolism were not significantly different. Postoperatively, carbohydrate metabolism recovered to preoperative levels after a transient decrease. These results demonstrated that postoperative motility improved over time although no difference was found among the 3 reconstruction routes used.
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PMID:Postoperative gastric motility, secretory function, and pre- and postoperative carbohydrate metabolic states in esophageal cancer patients. 874 35

Diurnal variation in intragastric pH in children with peptic ulcers has not been previously reported. Therefore, we monitored intragastric pH during a 24-h period in 82 subjects (10 children with gastric ulcers, 9 children with duodenal ulcers, 58 non-ulcer (comparison group) children, and 5 healthy adults) using a monopolar glass pH electrode. The percent of readings below pH 2, 3, 4, and 5 for each subject was calculated and compared between the comparison group and the two ulcer groups using means and slopes (i.e. changes in percent with age for each group) of percent readings for each pH analysis. In the comparison group children, gastric acidity increased with age and reached adult levels by 14 y. Mean readings for all pH analyses in gastric ulcer children were lower than those in age-adjusted comparison children (p < 0.05). The slopes of the relationships between age and the percent time below any pH for the gastric ulcer group were different from those in the comparison group (p < 0.05) and were negative for all pH analyses. The mean time below pH 2 in children with duodenal ulcers was greater than that in age-adjusted comparison children (p = 0.002). The slope of the relationship between age and the percent time below pH 2 in the duodenal ulcer group was different from that in the comparison group (p < 0.05). Gastric acidity in children with primary gastric ulcers was reduced during childhood, but in children with primary duodenal ulcer, gastric acidity was at or above adult levels.
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PMID:Diurnal variation in intragastric pH in children with and without peptic ulcers. 888 78


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