Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0847097 (acidity)
 15,165 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

High-fiber diets are being recommended by government agencies, cancer institutes, and manufacturers of high-fiber foods. Although this recommendation is appropriate for the majority of clients, some persons are prone to form phytobezoars and should not add certain kinds of fiber to the diet. The phytobezoar is a compact mass of fibers, skins, seeds, leaves, roots, or stems of plants that collects in the stomach or small intestine. Other food particles, such as fats, crystals, granules, fibers, and residues of salts, are incorporated into the mass and contribute to the growth of the bezoar. Clients who have undergone surgical procedures for peptic ulcer disease or stomach cancer or who for other reasons, such as diabetic gastroparesis, have a loss of normal pyloric function and decreased gastric acidity are prone to form phytobezoars. Once formed, the bezoar can be disintegrated through surgery, by the use of the Water Pik and enzymes during endoscopy, or by treatment with metoclopramide. The dietitian should advise such clients to avoid identified foods that lead to phytobezoar formation--oranges, persimmons, coconuts, berries, green beans, figs, apples, sauerkraut, brussels sprouts, and potato peel.
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PMID:Foods high in fiber and phytobezoar formation. 282 90

The H2-receptor antagonist, cimetidine, was used instead of magnesium trisilicate BPC as routine antacid therapy before both elective and emergency obstetric anesthesia. Two trials of its efficacy in increasing intragastric pH and decreasing the volume of gastric contents in parturients are reported. In the first trial, 400 mg of cimetidine given orally to patients being delivered by elective cesarean section effectively decreased gastric acidity, providing induction of anesthesia occurred 90-150 min after its administration. Of 62 patients requiring emergency anesthesia during active labor and who had been treated with 200 mg of cimetidine orally at 2-h intervals, 80% had gastric contents with a pH higher than 2.5. Failure to decrease gastric acidity to this level was mainly due to anesthesia being required within 60 min of the loading dose, but it also was considered that inaccurate timing of repeat doses and possibly delay in uptake due to gastric stasis by narcotic analgesia played a part. In trial 2 the same cimetidine regimen plus a 15-ml oral dose of 0.3 M sodium citrate given 10 min before induction of anesthesia was studied. All 72 women delivered by elective cesarean section had a low volume of gastric contents with pH greater than 2.5. Only 4% of 135 patients requiring emergency anesthesia had gastric aspirates the pH of which was less than 2.5. The volume (97 +/- 8.4 ml) of gastric contents removed from the latter patients were considered to still pose a hazard at induction of general anesthesia. No maternal or infant side effects related to cimetidine therapy were noted.
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PMID:Use of cimetidine as an oral antacid in obstetric anesthesia. 634 54

In duodenal ulcer disease, peptic digestion and ulceration of the duodenal mucosa can be related to increased duodenal acidity, which in about half the patients is due to inherited gastric hypersecretion, with too many parietal and chief cells. The others, normosecretors, may have parietal and chief cells excessively stimulated by, and/or specially sensitive to, gastrins and the vagus, together with inadequate suppression of the release of antral gastrin and the secretion of gastric acid. The abnormality is gastric hypersecretion with inappropriate hypergastrinaemia. The reserve capacities of the duodenal defence mechanisms are probably normal, but there seems to be a functional impairment with inadequate defence by decreased bicarbonate secretion into the duodenum, but as yet no clear impairment of the release of mucosal hormones. There are marked hereditary factors in gastric ulcer too. Some ulcers are related to gastric irritants (salicylates, tobacco). Oi's anatomical dual-control mechanism explains why gastric ulcers are usually solitary and at one site. Gastritis and duodenal reflux are probably the most important factors in type 1, body ulcers. Gastric stasis may be a factor in type 2, combined ulcers. Type 3 prepyloric ulcers resemble duodenal ulcers, both in blood group and hypersecretion.
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PMID:Current views on pathogenesis of peptic ulcer. 681 36

A prospective controlled trial of proximal gastric vagotomy (PGV) in 829 patients at three surgical services is presented. Peroperative tests of vagotomy completeness were made in two of the three groups of patients. The follow-up period was four to six years. The hospital stay after PGV averaged 9.2 days. The postoperative mortality rate was 0.2%. The reduction of gastric acidity was maintained four years after PGV. Postoperatively no patient had severe diarrhoea. The incidence of dumping after PGV was 1.5% and of gastric stasis 7.3%. Though 7% of the patients reported pyrosis after PGV, only a few required treatment. Transient dysphagia was reported by 2.5% of the patients. In about 4% of the series there were relatively mild ulcer-like symptoms postoperatively, without confirmation of ulcer. Duodenal ulcer recurred in 2% of cases during the observation period and gastric ulcer appeared in 1.5%. According to the Visick classification, 74% of the series showed grade I clinical result, 18% grade II, 4% grade III and 4% grade IV. There were no intergroup differences in Visick grades.
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PMID:Proximal gastric vagotomy. A prospective study of 829 patients with four-year follow-up. 683 26

A total of 37 subjects consisted of 10 healthy subjects (Group III), 15 diabetic patients without autonomic neuropathy (Group II), and 12 diabetic patients with autonomic neuropathy including gastroparesis in 6 cases (Group I). All three groups were comparable in age. In order to clarify the gastric function in diabetic patients with autonomic neuropathy, secretion of serum gastrin, gastric secretory function, endoscopic Congo red test of fundic glands, and coefficiency of variance of electrocardiographic beat-to-beat intervals (C.V. R-R) were examined. In Group I, 5 patients had hypergastrinemia, but its elevation was inhibited when an acid solution was injected into the stomach. Gastric secretion and C.V. R-R were markedly lower in Group I, compared with Groups II and III. In Group I, the area of fundic glands (parietal cells) was reduced considerably. The C.V. R-R was significantly correlated with fasting serum gastrin concentration and with maximal acid output. From these results, in diabetic patients with autonomic neuropathy (vagal neuropathy), gastric acid secretion in response to tetragastrin stimulation was lowered with a reduction in area of fundic gland distribution. Hypergastrinemia may reflect a negative feedback mechanism responding to decreased acidity of gastric content in the antrum.
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PMID:Decreased gastric secretory functions in diabetic patients with autonomic neuropathy. 781 84

Technical difficulties in creating gastrointestinal anastomosis in infants and young children, because of the small lumen, are well known and may be complicated by a narrow passage, anastomotic obstruction, gastric stasis, recurrent vomiting, and failure to gain weight. The search for alternative easier technique was the basis for this study. The primary aim was to evaluate the safety of anastomosis between the stomach and a loop of the jejunum performed by using the tissue adhesive Histoacryl glue in comparison with the same anastomosis performed conventionally with absorbable sutures. We compared the results of gastrojejunal anastomosis in rats using either Histoacryl (n-butyl cyanoacrylate) glue or continuous, absorbable sutures. Sixty-four Sprague-Dawley rats were divided into 4 groups of 16 rats each. Gastroenterostomy was performed with either type of anastomosis with and without truncal vagotomy. The criteria ofgastroenterostomy investigated included anastomotic leakage, stricture formation, adhesion formation, and histological examination. The pH of gastric secretion was measured with intact gastric innervation and after vagotmy in all rats. The time to complete each type of anastomosis was measured in minutes. Anastomotic stricture, leak, peritonitis, and death happened in three rats in each group with intact vagal innervation, in two rats after vagotomy and anastomosis with Histoacryl, and in one rat after vagotomy and anastomosis with sutures. The results showed no statistically significant differences between the various groups, except the shorter time for performing the glued anastomosis (5-7 min) compared to the conventional anastomosis (16-21 min). In conclusion, gastroenterostomy with Histoacryl in rats appears to be as safe as conventional suture anastomosis, saves operating time, and is not affected by gastric acidity.
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PMID:Gastrointestinal anastomosis with histoacryl glue in rats. 1129 56

Evidence suggests that distinct mechanisms underlie diabetic and idiopathic gastroparesis. Differences in gastric acid in gastroparesis of different etiologies and varying degrees of gastric stasis are uninvestigated. We tested the hypotheses that 1) gastric pH profiles show differential alteration in diabetic vs. idiopathic gastroparesis and 2) abnormal pH profiles relate to the severity of gastric stasis. Sixty-four healthy control subjects and 44 gastroparesis patients (20 diabetic, 24 idiopathic) swallowed wireless transmitting capsules and then consumed (99m)Tc-sulfur colloid-labeled meals for gastric scintigraphy. Gastric pH from the capsule was recorded every 5 s. Basal pH was higher in diabetic (3.64 +/- 0.41) vs. control subjects (1.90 +/- 0.18) and idiopathic subjects (2.41 +/- 0.42; P < 0.05). Meals evoked initial pH increases that were greater in diabetic (4.98 +/- 0.32) than idiopathic patients (3.89 +/- 0.39; P = 0.03) but not control subjects (4.48 +/- 0.14). pH nadirs prior to gastric capsule evacuation were higher in diabetic patients (1.50 +/- 0.23) than control subjects (0.58 +/- 0.11; P = 0.003). Four-hour gastric retention was similar in diabetic (18.3 +/- 0.5%) and idiopathic (19.4 +/- 0.5%) patients but higher than control subjects (2.2 +/- 0.5%; P < 0.001). Compared with control subjects, those with moderate-severe stasis (>20% retention at 4 h) had higher basal (3.91 +/- 0.55) and nadir pH (2.23 +/- 0.42) values (P < 0.05). In subgroup analyses, both diabetic and idiopathic patients with moderate-severe gastroparesis exhibited increased pH parameters vs. those with mild gastroparesis. In conclusion, diabetic patients with gastroparesis exhibit reduced gastric acid, an effect more pronounced in those with severely delayed gastric emptying. Idiopathic gastroparetic subjects exhibit nearly normal acid profiles, although those with severely delayed emptying show reduced acid vs. those with mild delays. Thus both etiology and degree of gastric stasis determine gastric acidity in gastroparesis.
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PMID:Differences in intragastric pH in diabetic vs. idiopathic gastroparesis: relation to degree of gastric retention. 1840 19