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

Two cases of gastro-colic fistula occurring in analgesic abusers are described. In both patients, the fistulous communication was diagnosed at endoscopy and subsequently verified by upper gastrointestinal tract barium studies. Gastro-colic fistula is a rare complication of benign peptic ulcer disease. Whilst salcylates and cortico-steroids have been implicated as aetiological agents, abuse of compound analgesics has not previously been reported. Since the first description of gastro-colic fistula in 1755, thirty documented cases associated with benign gastric ulcer have been reported. Most often, gastro-colic fistula occurs secondary to gastric or colonic malignancy. Barium enema examination is the most accurate diagnostic study. Endoscopy has been confined to the visual inspection of the ulcer and establishing the benign nature of these lesions.
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PMID:Gastro-colic fistula complicating benign gastric ulcer in analgesic abusers. 28 2

Carbenoxolone sodium has been shown to accelerate the rate of healing of both gastric and duodenal ulcers, but its overall value in duodenal ulcer is probably less because of the high rate of natural remission of duodenal ulcers. Further studies are required to decide whether it should be used prophylactically to delay ulcer recurrence. Carbenoxolone may act by affecting both the proliferative activity of gastric epithelium and the differentiation of the epithelial cells to produce mucus (as well as favourably altering the physicochemical properties of mucus and by reducing peptic activity), factors which may be relevant ot the prevention of acute gastric ulcers. Some studies suggest that carbenoxolone adds to the effect of hospitalisation and bed rest on ulcer healing. Whether bed rest confers additional benefit to the drug's ulcer healing effect in outpatients is also uncertain. There is no evidence that accelerated healing by carbenoxolone is associated with improved overall prognosis. Carbenoxolone is of greatest benefit in accelerating the healing of gastric ulcers in patients for whom hospitalisation is not possible or desirable, but it should only be used in the ambulatory patient when careful and regular observation of serum electrolytes (particularly potassium), blood pressure and weight is possible and when it is known that the patient will attend regular follow-up. Patient must be educated in the proper use of the drug. If severe mineralocorticoid-like toxic effects such as sodium and water retention and hypokalaemia appear, as they do in a variable proportion of patients but most frequently in those receiving excessive doses, carbenoxolone should be stopped and the complication treated; they respond to thiazide diuretics and potassium supplements, and probably to amiloride given in conjunction with a low dose of a thiazide diuretic. Treatment with carbenoxolone can continue with concurrent diuretic therapy in patients with less severe side-effects. Optimum therapeutic effect in gastric ulcer with the least side-effects is achieved with a dosage of 100mg carbenoxolone tablets 3 times daily for the first week followed by 50mg 3 times daily thereafter, best taken before meals. A lower dosage is desirable in the elderly and in those with liver, cardiac or renal disease. Barium meal or preferably endoscopic examinations should be performed regularly and therapy continued until the ulcer is healed. Dosage for duodenal ulcer is 50mg 4 times daily, in special positioned-release capsules. These are best taken about 20 minutes before meals.
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PMID:Carbenoxolone: a review of its pharmacological properties and therapeutic efficacy in peptic ulcer disease. 78 88

A case report and review of the literature of benign gastric ulcer complicated by gastrocolic fistula are presented. Twenty-seven percent of patients were found to be receiving ulcerogenic medications. Only 15% of patients had previous histories of ulcer disease. Parameters most suggestive of a neoplastic process included palpable abdominal mass and unexplained anemia. Diagnosis is established by barium enema. Endoscopic biopsy and cytologic studies are useful in differentiating benign from malignant processes. Surgical management of benign ulcers complicated by fistula results in more than 90% survival.
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PMID:Gastrocolic fistula secondary to benign gastric ulcer not operated upon: case report and review of literature. 84 2

We report a case of gastrocolic fistula resulting from a benign gastric ulcer, diagnosed by barium meal and endoscopy. The fistula healed with conservative management and treatment with carbenoxolone sodium. To our knowledge this is the first reported case of successful conservative treatment of a benign gastrocolic fistula using carbenoxolone.
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PMID:Benign gastrocolic fistula healing with conservative management. 85 67

A prospective study to determine the incidence of hiatus hernia and gastro-oesophageal reflux in 1030 consecutive symptomatic adult Nigerian patients undergoing barium meal examination is reported. The results show a very low incidence of hiatus hernia (0-39%) and an equally low incidence of gastro-oesophageal reflux (2-2%) when compared with similar studies in Europe and America. There was a high incidence of duodenal ulcer (23-3%) and a low incidence of gastric ulcer (1-8%), the duodenal/gastric ulcer ratio of 12-1:1 being much higher than in Europe.
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PMID:Incidence of hiatus hernia and gastro-oesophageal reflux in 1030 prospective barium meal examinations in adult Nigerians. 88 53

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

General pharmacological properties of penfluridol (TLP-607) a long-acting antipsychotic drug, were examined in experimental animals and the following results were obtained. 1) TLP-607 produced a lowering of arterial blood pressure and bradycardia but had almost no effect on respiration and peripheral blood flow. 2) TLP-607 slightly hypertension induced by dopamine, adrenaline and noradrenaline, but had no effect on hypotension induced by acetylcholine and histamine. 3) Antagonistic actions of TLP-607 on such spasmogens as acetylcholine, histamine and barium chloride were slightly stronger than those of haloperidol and chlorpromazine. 4) TLP-607 had neither ganglionic nor neuromuscular blocking action. 5) TLP-607 had a slight or no effect in the following experiments; protection against stomach ulcer, activity of ileum and uterus in vivo and in vitro, urinary volume and electrolytes excretion, and gastro-intestinal propulsion. These results suggest that TLP-607 has no striking peripheral actions in experimental animals.
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PMID:[Pharmacological studies of antipsychotic drug, penfluridol. 2. General pharmacological properties]. 103 5

Multiple gastric biopsies were performed with a duodenofiberscope in 58 Chinese subjects. All 58 cases had a gastric ulcer crater, demonstrated by endoscopy, or barium meal, or both. Histological sections of the gastric biopsies showed chronic atrophic gastritis in 12 (20.6%), chronic gastritis in 31 (53.4%), and acute-on-chronic gastritis in 11 (19%). Only two cases or 3.4% had normal gastric mucosa, while 54 cases or 93% had some form of chronic gastritis, on the gastric biopsy. The gastritis was associated with intestinal metaplasia in 16 cases (27.6%), while two cases had histological evidence of gastric atypia. No significant difference was found in the mean basal and peak acid outputs among the three groups of gastric ulcer cases with chronic atrophic gastritis, chronic gastritis, and acute-on-chronic gastritis. The high frequency of chronic gastritis (93%) occurring in patients with gastric ulcer in the present series suggests that chronic gastritis may be an important aetiological factor in the pathogenesis of gastric ulceration.
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PMID:The prevalence of chronic gastritis in patients with gastric ulcer. 105 23

During 2 1/2 year period in Port Moresby General Hospital, 1023 patients had barium meals. Two-thirds of the patients were males and over half were expatriates. Positive findings were noted in 26% of Papua New Guineans but only 11% of expatriates. Over half of those with positive findings had peptic ulcer. Chronic duodenal ulcer, including deformed duodenal cap, was the commonest finding in both Papua New Guineans and expatriates but gastric ulcer was also common in Papua New Guinean males. The incidence of peptic ulcer is less than that reported in Goroka and in some other countries. The next commonest findings were carcinoma of the oesophagus and stomach in Papua New Guineans and hiatus hernia in expatriate males.
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PMID:A radiological survey of upper gastrointestinal lesions in Port Moresby 1972-74. 107 69

The initial aim was to program a computer with information on the frequency of radiological signs in benign and malignant gastric ulcers in order to obtain a percentage probability of benignancy or malignancy in succeeding ulcers in clinical practice. However, only four of the many signs described in gastric ulcer were confirmed to be of validity (i.e. reliable existence) by an inter-observer variation study using two observers and the films from 69 barium meal examinations. These were projection or non-projection of the in-profile ulcer, presence or absence of adjacent mucosal folds, good or poor definition of the in-face ulcer's edge, and extension of radiating folds to the in-face ulcer's edge. A few more remained unassessed due to insufficient numbers of relevant cases. It is condluced that: as defined in the literature the majority of radiological signs in this field are of uncertain existence; and the four that were found to be valid do not fully describe the important appearances that may be seen in benign and malignant ulcers and would be inadequate to differentiate them to a sufficiently high degree of probability.
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PMID:The definition of radiological signs in gastric ulcer and assessment of their validity by inter-observer variation study. 110 43


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