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

Four cases of gastrocolic fistula complicating benign gastric ulcer are described, bringing the total number of individually reviewed cases in the English language literature to 108. A review of 30 cases reported in the past 10 years reveals a surprisingly high percentage of young, female patients. Three-quarters of these patients used steroidal or nonsteroidal anti-inflammatory agents. The presence of such fistulae is suspected in patients complaining of weight loss, diarrhoea and faecal vomiting. Small fistulae may not be suspected when overshadowed by other complications of ulcer disease such as bleeding or perforated viscus. Medical management of benign gastrocolic fistulae may be indicated in some circumstances. Surgical treatment involves en bloc resection, including the fistula, and surrounding colon and gastric segments.
Br J Surg 1989 Dec
PMID:Gastrocolic fistula as a complication of benign gastric ulcer: report of four cases and update of the literature. 269 Oct 14

The efficacy of ranitidine (150 mg nocte), and sucralfate (1 g tds) as maintenance therapy to prevent gastric ulcer relapse was evaluated in a 12 month trial in 363 patients. The relapse rates were 8.8% at three months, 14.7% at six months, 18.1% at nine months, and 21.0% at 12 months for the ranitidine group and 14.7%, 21.3%, 29.9%, and 30.2% respectively for the sucralfate group. At nine and 12 months the cumulative relapse rates for the ranitidine group were significantly lower than those for the sucralfate group (p less than 0.05). In both groups ulcers recurred mainly from red scars observed at the endoscopic scarring stage. This indicated the necessity of drug treatment up to the white scar stage. The results suggest that ranitidine is effective in preventing gastric ulcer relapse.
Gut 1989 Dec
PMID:Ranitidine and sucralfate as maintenance therapy for gastric ulcer disease: endoscopic control and assessment of scarring. 269 31

The long term clinical results after proximal gastric vagotomy (PGV) for peptic ulcer were determined among 396 patients who underwent surgical treatment at the Mayo Medical Center between 1973 and 1981. PGV was performed for duodenal ulcer (n = 293), midgastric ulcer (n = 14), prepyloric or pyloric ulcer (n = 46) and combined gastric, pyloric, prepyloric and duodenal ulcers (n = 43). Postoperative follow-up observation ranged from five to 13 years (a mean of eight years) and was complete in 96 per cent of the patients. There was no perioperative mortality. Severe dumping and diarrhea were uncommon (less than 1 per cent), and only eight patients (2 per cent) had reoperations for nonulcerative complications. Documented recurrent ulcer appeared in 55 patients (14 per cent). Kaplan-Meier estimates of the probabilities of recurrence at five and ten years after PGV, respectively, were duodenal ulcer, 6 and 12 per cent; gastric ulcer, 16 and 16 per cent; pyloric or prepyloric ulcer, 12 and 39 per cent, and combined ulcers, 26 and 33 per cent. Reoperation for recurrence was required in only 16 of the 55 patients (29 per cent). We conclude that PGV for peptic ulcer is a safe operation with few serious side effects. When used to treat duodenal and perhaps midgastric ulcers, PGV has an acceptable long term recurrence rate. The high incidence of recurrent ulcer after PGV for pyloric or prepyloric or combined ulcers suggests that alternative operations should be performed for ulcers in these locations.
Surg Gynecol Obstet 1989 Dec
PMID:Long term clinical results after proximal gastric vagotomy. 281 64

A double-blind, placebo-controlled study was carried out to see whether the synthetic E prostaglandin, misoprostol, would prevent gastric ulcer induced by non-steroidal anti-inflammatory drugs (NSAIDs). 420 patients with osteoarthritis and NSAID-associated abdominal pain were studied; they were receiving ibuprofen, piroxicam, or naproxen. Endoscopy was done at entry and after 1, 2, and 3 months of continuous treatment with 100 micrograms or 200 micrograms misoprostol or placebo, given four times daily with meals and at bedtime, concurrently with the NSAID. Abdominal pain was rated independently by patients and physicians. A treatment failure was defined as development of a gastric ulcer. Gastric ulcers (0.3 cm in diameter or greater) occurred less frequently (p less than 0.001) in both misoprostol treatment groups (5.6% 100 micrograms and 1.4% 200 micrograms) than in the placebo group (21.7%). The significant difference in ulcer formation between the placebo and the misoprostol treatment groups remained when comparisons were restricted to ulcers greater than 0.5 cm in diameter (12.3% placebo, 4.2% 100 micrograms misoprostol, and 0.7% 200 micrograms misoprostol). Mild to moderate, self-limiting diarrhoea was the most frequently reported adverse effect attributed to misoprostol. These results provide the first clear indication that NSAID-induced ulcers are preventable.
Lancet 1988 Dec 03
PMID:Prevention of NSAID-induced gastric ulcer with misoprostol: multicentre, double-blind, placebo-controlled trial. 290 6

Analysis of clinical data obtained in a double-blind randomized study, which compared liquid antacid (neutralizing capacity 120 mmol per day) with 1 g cimetidine in the treatment of 125 patients with gastric ulcer, revealed that, before starting treatment, 71% of the patients complained of epigastric pain, approximately 50% of bloating, and approximately 30% of nausea, heartburn, constipation or vomiting. Epigastric pain before treatment was significantly more frequent in patients with large ulcers (P less than 0.05) and in patients with ulcers unhealed after 4 weeks of therapy (P less than 0.05). This finding was the result of a highly significant correlation between diurnal epigastric pain and ulcer size and delayed healing (P less than 0.005). Nocturnal pain did not correlate with prognosis. In contrast to this correlation between pain before therapy and healing, the disappearance of epigastric pain with therapy did not signify ulcer healing. Only 14 (38%) of the 37 patients with healed ulcer were free from pain after the 4 weeks of therapy, whereas 25 (49%) of the 52 patients with persistent ulcers had no pain at this time. Placebo pain tablets relieved ulcer pain effectively in more than 85% of the patients, irrespective of whether the ulcer was healing or not. The other symptoms (bloating, nausea, heartburn, constipation or vomiting) were also alleviated by 4 weeks of therapy but no correlation was found with ulcer size or prognosis. The loss of the prognostic significance of ulcer pain is probably due to a complex interaction of the trial schedule on the patient's level of consciousness.(ABSTRACT TRUNCATED AT 250 WORDS)
Aliment Pharmacol Ther 1988 Dec
PMID:Loss of predictive value of gastric ulcer symptoms in a randomized treatment trial. 297 76

The personality profiles, as evaluated with Cattell's 16 personality factors test (16 PF), were compared in 25 subjects with gastric ulcer, 25 with duodenal ulcer and 25 healthy controls. Subjects were matched for sex, age, education, geographical area of living and duration of illness (only for patients). The profiles of the gastric and duodenal ulcer patients were substantially similar and characterized by greater anxiety, dependence, introversion, low ego strength and greater adaptability as compared to the controls. Patients with gastric ulcer, however, seemed to be slightly more disturbed than those with duodenal ulcer.
Gastroenterol Clin Biol 1988 Dec
PMID:Personality factors in chronic gastric and duodenal ulcers: a controlled study. 306 48

An 83-year-old woman with no history of vascular surgery presented with a fatal upper gastrointestinal bleed from an aortogastric fistula secondary to a penetrating gastric ulcer. The fistula was between the thoracic aorta and the gastric ulcer in a hiatus hernia. On autopsy, a discrete 1-cm ulcer had perforated into the otherwise normal thoracic aorta. Aortogastric fistula involving the thoracic aorta and a gastric ulcer is rare in the absence of vascular graft surgery or aneurysm. We review the pertinent literature.
J Clin Gastroenterol 1987 Dec
PMID:Aortogastric fistula from hiatal hernia ulcer. A cause of massive upper gastrointestinal bleeding. 332 87

Data on duodenogastric reflux of bile in gastric ulcer are conflicting. We therefore measured intragastric bile acid concentration and its composition from individual bile acids, duodenogastric bile acid reflux rate, gastric emptying rate, and secretion rates of volume and acid in 30 patients with gastric ulcer and in 66 healthy controls, both in the fasting state and after feeding a liquid meal. Patients had higher gastric bile acid concentrations (p less than 0.05) than controls in the fasting state, but the overlap between the groups was considerable. In fasting patients with corpus ulcer, gastric secretion rates were significantly decreased when compared with controls. There was no difference between patients and controls with respect to gastric emptying rate, bile acid reflux rate, intragastric amount of bile acids, and bile acid composition in the fasting state. Postprandially, all parameters tested were similar in patients and controls. Controls showed high reflux rates with similar frequency as did ulcer patients. We conclude that increased gastric bile acid concentrations in the fasting stomach of patients with gastric ulcer are the result of gastric hyposecretion and not of increased reflux. They probably are pathogenetically irrelevant.
Gut 1987 Dec
PMID:Healthy controls have as much bile reflux as gastric ulcer patients. 342 84

A hundred and one cases of gastric ulcer were examined in Poland by direct-vision endoscopic biopsy obtained from the antrum, angulus and body far outside the ulcer area, and from the edge of the ulcer. A simple mean score of gastritic changes and of intestinal metaplasia (IM) was calculated for each area, as also a mean score of IM for the mucosa around the ulcer. Two re-examinations were performed, one on average 2 months and the other on average 4.5 years, after the first examination. On the whole, gastritic changes and IM behaved as expected from earlier studies. The most striking finding was the high mean score of the angular mucosa in the case of more proximally situated ulcers. This angular peak was present at all examinations and both in patients healed during the follow-up and those in whom the disease remained active. A corresponding peak of gastritic changes and IM at the angulus was not found in more comprehensive Finnish control material, but was present in another smaller outpatient series, although the differences between the angulus and surrounding tissues were insignificant. At the first examination the mean scores of gastritis and of IM outside and around the ulcer were higher in patients with proximal ulcers in whom the ulcer healed during the observation period than in those, in whom it remained active. This difference was found at the first and at all subsequent examinations, and some of the differences were statistically significant.(ABSTRACT TRUNCATED AT 250 WORDS)
Hepatogastroenterology 1987 Dec
PMID:Gastric ulcer and gastritis: results of short-term follow-up examinations. 342 59

The frequency of duodenal and gastric ulcer disease, the thickness of the pyloric muscle, and adhesions of the duodenum were evaluated in a routine, consecutive, prospective autopsy series of 100 patients, and the length of the pyloric canal, adhesions of the duodenum, and motility disturbances in the upper gastrointestinal series were studied in a separate radiologic material of 69 symptomatic patients with cholecystectomy in their history. Both series were compared with matched unoperated controls. The frequency of active gastric ulcers and ulcer scars was observed to be increased and that of active duodenal ulcers and ulcer scars decreased among the cholecystectomized patients in the autopsy series (p = 0.01 in both cases). This difference was not as pronounced when only active ulcers were included, but for active duodenal ulcers the difference was still significant (p = 0.04). One-fourth of the cholecystectomized patients but none of the controls had severe adhesions of the duodenum. In the autopsy series the thickness of the pyloric muscle and in the radiologic series the length of the radiologic pyloric canal were thickened/lengthened in an average of 26%/11% in patients who had undergone cholecystectomy (p less than 0.001 and p less than 0.10, respectively). The lengthening of the pyloric canal was in significant positive correlation with the motility disturbance/adhesion score of the upper gastrointestinal series.(ABSTRACT TRUNCATED AT 250 WORDS)
Scand J Gastroenterol 1987 Dec
PMID:Gastroduodenal peptic ulcers, duodenal adhesions, and upper gastrointestinal motility disturbances in patients who have undergone cholecystectomy. 343 8


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