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

The effects of a new carbenoxolone analogue (BX24), zinc sulphate, and vitamin A on the healing of gastric ulcer have been assessed in a multifactorial clinical trial conducted in out-patients treated for four weeks.Forty-eight patients completed the trial. Three groups of eight patients were given respectively 300, 600, and 1 200 mg of BX24 daily and were compared with 24 patients who were given 300 mg of carbenoxolone sodium daily. The size of the ulcer niche was reduced on average by 14.6% in the eight patients given BX24 300 mg daily, by 47.6% in the patients given 600 mg daily, and by 51.0% in the patients given 1 200 mg daily. In the patients given carbenoxolone the size of the niche was reduced by 68.9%. These results were compared with those obtained previously with carbenoxolone and inert tablets and it was concluded that BX24 is without clinically useful effect in the doses used. Eleven of the 24 patients (46%) treated with carbenoxolone sodium developed side effects due to fluid retention and electrolyte disturbances. None of the patients given BX24 experienced such effects. In addition to carbenoxolone or BX24, 24 patients were given zinc sulphate, 660 mg daily, and in 24 patients these tablets were withheld. Among the patients given carbenoxolone the reduction in the size of the niche was much the same irrespective of whether or not the patients received zinc sulphate. Among the 12 patients given BX24 with zinc sulphate the ulcer healed completely in four and, on average, the size of the niche was reduced by 53.5%, compared with 21.9% in the 12 patients given BX24 alone. This difference is not statistically significant but the possibility of a beneficial effect from zinc is not excluded. No side effects attributable to zinc were observed.Twenty-four patients were also given vitamin A, 50 000 units daily, and in 24 patients the vitamin was withheld. No evidence was obtained to suggest that vitamin A had any beneficial effect on the healing of gastric ulcer.
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PMID:Clinical trial of a new carbenoxolone analogue (BX24), zinc sulphate, and vitamin A in the treatment of gastric ulcer. 455 8

A formal metabolic study of carbenoxolone sodium (Biogastrone) 300 mg./day has been performed for 17 days on a woman with gastric ulcer who in a previous 21-day trial, on a 52-mEq sodium diet, showed weight gain, retention, and rise in plasma sodium and chloride concentrations, as well as hypokalaemia without change in potassium balance. In the present trial sodium intake was restricted to 26 mEq/day; while plasma electrolyte changes of lesser degree still occurred, there was no retention of water, sodium, or chloride. Aldosterone secretion in the control period was 202 mug./24 hours, and fell to 74 mug./24 hours after carbenoxolone, but plasma renin was unchanged.These results suggest that the mineralocorticoid effects of carbenoxolone (and presumably of liquorice and its other derivatives) are due to an intrinsic aldosterone-like action, and that, with sodium deprivation, aldosterone secretion is suppressed by a mechanism which is not renin-mediated-possibly hypokalaemia.
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PMID:Metabolic studies, aldosterone secretion rate, and plasma renin after carbenoxolone sodium. 578 14

The aetiopathogenesis of gastric ulceration suggests that though gastric acid plays an essential role, damage to the gastric mucosal barrier may be of more importance. Gastric ulceration is a complex disease and certain factors such as the size and site of the ulceration may influence healing. If these are not carefully standardised assessment of various therapeutic agents may produce conflicting results. The factor which has perhaps most influenced the approach to therapy of gastric ulcers is the difficulty in differentiating benign from malignant ulceration. The first accepted form of treatment for gastric ulceration was carbenoxolone sodium and though a high incidence of side effects were reported with its use, it enabled treatment on an outpatient basis. More recently the histamine H2-receptor antagonists have been shown to be equally effective and minimal reported adverse effects have made them the treatment of choice. Newer drugs are available but are yet to be fully evaluated. At present maintenance therapy is not advisable in patients with gastric ulceration unless the risk of relapse in these patients outweighs the danger of delaying diagnosis of malignancy. Where maintenance therapy is used patients should be closely monitored clinically and endoscopically.
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PMID:Medical management of gastric ulcer. 614 87

Various lines of evidence indicate that aldosterone and prostaglandins may play physiological roles in protecting the gastric mucosa. This would suggest that low-sodium, high-potassium diets, and supplementation with essential fatty acids that are efficient prostaglandin precursors (as in evening primrose oil), may have value in the prevention and treatment of gastric ulcer and gastritis. A low-sodium, high-potassium diet may also reduce the risk of gastric cancer.
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PMID:Nutritional modulation of mineralocorticoid and prostaglandin production: potential role in prevention and treatment of gastric pathology. 635 85

The efficacy of local-acting De-Nol liquid (tripotassium dicitrato bismuthate) was investigated in patients with endoscopically verified gastric ulcer. In a prospective-type clinical trial, 16 outpatients received De-Nol and 24 outpatients received an antacid mixture (sodium bicarbonate, calcium carbonate, magnesium trisilicate in equal parts). The period of study was 4 weeks, the endoscopy being performed on the 14th and 28th day after commencement of treatment. We Registration was made of the degree of ulcer healing (ulcer is healed, or not healed but reduced by 50%, or slightly healed, or unchanged), the degree of pain (0 = none, 1 = slight, 2 = moderate, 3 = severe), body weight, different biochemical and haematological examinations, side-effects and some other parameters. Of those patients given De-Nol treatment, the ulcer healed in 69% within four weeks, as compared with 33% of those given antacid therapy. There was also a significant (p less than 0.001, p less than 0.02) difference between the two groups in the size of the ulceration which remained and in the decrease of pain. Side-effects were not recorded. These data suggest the beneficial effect of De-Nol liquid in the treatment of patients with gastric ulceration.
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PMID:A controlled clinical trial with De-Nol (tripotassium dicitrato bismuthate) in patients with gastric ulcer. 636 45

The influence of oral carbenoxolone sodium (50 mg X 3 daily) on prostaglandin E2 release into gastric juice has been examined in nine peptic ulcer patients (duodenal ulcer, n = 6; prepyloric ulcer, n = 1; gastric ulcer, n = 2) during modified sham feeding and following bolus stimulation of acid secretion by pentagastrin (6 micrograms/kg). Carbenoxolone increased the overall mean of prostaglandin E2 concentrations in gastric juice following modified sham feeding by 32 +/- 9% (mean +/- SEM; P less than 0.02) and decreased the acidity slightly but significantly (P less than 0.05). A marked rise in prostaglandin E2 levels (46 +/- 11%; n = 5; P less than 0.02) was observed in for duodenal ulcer patients and the patient with a prepyloric ulcer responding to therapy (i.e., pain relief and ulcer healing within 4 weeks of treatment). A significant peak (P less than 0.05) related to modified sham feeding was observed only during medication, while a late gradual increase in prostaglandin E2 levels--not associated with vagal stimulation--occurred both in control and carbenoxolone experiments. No significant differences were observed following pentagastrin stimulation. The initial peak in prostaglandin E2 levels observed during medication favours the notion that the mechanism of drug action relies on inhibition of enzymatic degradation while the late increase in prostaglandin E2 levels may be explained by artificial prostaglandin formation during the aspiration procedure.
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PMID:Effect of carbenoxolone on gastric prostaglandin E2 levels in patients with peptic ulcer disease following vagal and pentagastrin stimulation. 641 22

The effect of different antacids has been investigated on ulcer development, parameters of mucus barrier disruption and gastric PGE2 content in rats. Al(OH)3-containing antacids inhibit gastric ulcer formation induced by alcohol or acetylsalicylic acid (ASA). Changes in parameters of mucus barrier disruption evoked by sodium taurocholate can be significantly diminished by treatment with antacids. This protective effect of antacids is abolished in animals pretreated with indomethacin. PGE2 contents both in gastric mucosa and instillate are increased by pretreatment with antacids. PGE2 content in gastric mucosa or instillate diminished by sodium taurocholate can be normalized by antacid treatment. Although acidic isotonic or acidic hypertonic solutions increase gastric PGE2 content, they are not ulceroprotective. In these solutions, detectable amounts of released PGE2 are minimal. Under in vitro circumstances, the lifetime of PGE2 in gastric juice is shortened by decreasing pH. It has been concluded that Al(OH)3-containing antacids increase PGE2 content in the gastric mucosa. Furthermore, they are capable of lengthening the lifetime of PGE2 in the gastric content. Thus, the clinical use of Al(OH)3-containing antacids in low doses is to be emphasized in the management of gastric ulcer disease.
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PMID:Functional cytoprotection by certain antacids. 659 1

The effect of lysophosphatidylcholine (lysoPC) on the guinea pig stomach was studied. At concentrations observed in gastric secretions of gastric ulcer patients (1 to 2 mM), lysoPC induced both functional and morphologic changes in the gastric mucosa. Two millimolar lysoPC caused back diffusion of H+ and forward diffusion of Na+, indicating impairment of the gastric mucosal barrier. In the lysoPC-treated stomachs, an increase was observed in 1) the number of mucosal erosions, 2) the intensity of inflammation, and 3) the degree of vascular congestion. Microvascular plugging by platelets, vascular stasis, and polymorphonuclear leukocyte margination were dose-responsive to lysoPC. Pretreatment of animals with aspirin (20 mg/kg) did not alter injury. These results indicate a role of lysoPC reflux in gastric mucosal injury, including mucosal erosions and ulcerations.
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PMID:Lysophosphatidylcholine-induced gastric injury and ulceration in the guinea pig. 672 Aug 71

Patients with benign gastric ulcer were treated for four weeks with carbenoxolone sodium as Biogastrone tablets 100 mg three times a day, and if the ulcers were not healed at 4 weeks treatment was continued for a further 4 weeks. Fifty two patients entered the trial, and 12 were withdrawn. In 17 patients who were randomly allotted double-blind additional dummy tablets 16 of their ulcer healed completely endoscopically, whereas of the 23 patients given additional amiloride 5 mg three times a day only 14 ulcers healed, a significant reduction in ulcer healing. The clinical (weight gain and oedema) and metabolic (hypertension, hypokalaemia and hypernatraemia) side-effects were reduced by the active amiloride therapy, but serum carbenoxolone levels were not affected. Thus the potassium-retaining diuretic amiloride, like the aldosterone antagonist spironolactone, markedly reduces both the ulcer-healing and the metabolic side-effects of carbenoxolone sodium, and should not be used together with it in the treatment of peptic ulcer.
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PMID:The influence of amiloride on the therapeutic and metabolic effects of carbenoxolone in patients with gastric ulcer. A double-blind controlled trial. 701 May 28

Carbenoxolone was compared with placebo in a randomised double-blind study involving 40 patients with gastric ulcer (20 each in the treated and placebo groups). The evaluation was based on eight variables. The endoscopic findings on completion of 4 or 6 weeks of treatment, revealed greater improvement in response to carbenoxolone than to placebo. The difference was statistically significant at the previously fixed level of significance of p less than 0.05. The plasma potassium level fell significantly in the treated group but the actual reduction of 7% was slight. No statistically significant differences were measured in any of the other variables, i.e. plasma sodium, SGOT, SGPT, systolic and diastolic blood pressure, bodyweight, or oedema formation.
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PMID:Carbenoxolone patients with gastric ulcers. A double-blind trial. 701 May 29


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