New ways in the treatment of gastric ulcer and duodenal ulcer

1936 ◽  
Vol 32 (8) ◽  
pp. 909-916
Author(s):  
Ya. I. Daikhovsky

If until now the views of most authors still diverge on the pathogenesis of gastric ulcers, then there is complete unanimity in assessing the role of the nervous system in the development and course of gastric ulcers and duodenal ulcers, stomach ulcers and duodenal ulcers have long ceased to be considered as local disease, it is a manifestation of a disease of the whole organism with the localization of the process in the stomach or duodenal ulcer, which finds its expression in the term peptic ulcer disease. This view, firmly established in medicine, on stomach and duodenal ulcers is impossible, of course, not consider when it comes to treating this suffering.

2018 ◽  
Author(s):  
Edward A Lew

Peptic ulcers are defects or breaks in the inner lining of the gastrointestinal (GI) tract. Although the pathogenesis is multifactorial they tend to arise when there is an imbalance between protective and aggressive factors, such as when GI mucosal defense mechanisms are impaired in the presence of gastric acid and pepsin. Peptic ulcers extend through the mucosa and the muscularis mucosae, a thin layer of smooth muscle separating the mucosa from the deeper submucosa, muscularis propria, and serosa. Peptic ulcer disease affects up to 10% of men and 4% of women in Western countries at some time in their lives. This chapter discusses the pathogenesis of peptic ulcer disease and the etiologic contribution of Helicobacter pylori infection, nonsteroidal anti-inflammatory drugs, and gastrinoma or other hypersecretory states. Also addressed are rare and unusual causes for ulcers and GI bleeding. A section on the diagnosis of peptic ulcers discusses clinical manifestations, physical examination findings, laboratory and imaging studies, and surgical diagnosis. Differential diagnosis is also reviewed. Tests to establish the etiology of peptic ulcer disease include endoscopy, quantitative serologic tests, the urea breath test, and the fecal antigen test. Discussed separately are treatments for uncomplicated duodenal ulcers, uncomplicated gastric ulcers, intractable duodenal or gastric ulcers, complicated peptic ulcers (bleeding ulcers, acute stress ulcers, perforated ulcers, obstructing ulcers, fistulizing ulcers, and Cameron ulcers), H. pylori ulcers, and gastric cancer. Figures illustrate the etiopathogenesis of peptic ulcers, prevalence of H. pylori infection in duodenal and gastric ulcer patients compared with normal controls, the approach to a patient with new and undiagnosed ulcerlike symptoms refractory to antisecretory therapy, an upper GI series showing an uncomplicated duodenal ulcer, a chest x-ray showing pneumoperitoneum from a perforated duodenal ulcer, gastric biopsy samples showing H. pylori organisms, and the approach to treatment and follow-up in patients with either complicated or uncomplicated duodenal or gastric ulcer. Tables list differential diagnoses of peptic ulcer disease, commonly used regimens to eradicate H. pylori, additional antimicrobial agents with activity against H. pylori, and FDA-approved antisecretory drugs for active peptic ulcer disease. This chapter contains 76 references.


2020 ◽  
Author(s):  
Edward A Lew

Peptic ulcers are defects or breaks in the inner lining of the gastrointestinal (GI) tract. Although the pathogenesis is multifactorial they tend to arise when there is an imbalance between protective and aggressive factors, such as when GI mucosal defense mechanisms are impaired in the presence of gastric acid and pepsin. Peptic ulcers extend through the mucosa and the muscularis mucosae, a thin layer of smooth muscle separating the mucosa from the deeper submucosa, muscularis propria, and serosa. Peptic ulcer disease affects up to 10% of men and 4% of women in Western countries at some time in their lives. This chapter discusses the pathogenesis of peptic ulcer disease and the etiologic contribution of Helicobacter pylori infection, nonsteroidal anti-inflammatory drugs, and gastrinoma or other hypersecretory states. Also addressed are rare and unusual causes for ulcers and GI bleeding. A section on the diagnosis of peptic ulcers discusses clinical manifestations, physical examination findings, laboratory and imaging studies, and surgical diagnosis. Differential diagnosis is also reviewed. Tests to establish the etiology of peptic ulcer disease include endoscopy, quantitative serologic tests, the urea breath test, and the fecal antigen test. Discussed separately are treatments for uncomplicated duodenal ulcers, uncomplicated gastric ulcers, intractable duodenal or gastric ulcers, complicated peptic ulcers (bleeding ulcers, acute stress ulcers, perforated ulcers, obstructing ulcers, fistulizing ulcers, and Cameron ulcers), H. pylori ulcers, and gastric cancer. Figures illustrate the etiopathogenesis of peptic ulcers, prevalence of H. pylori infection in duodenal and gastric ulcer patients compared with normal controls, the approach to a patient with new and undiagnosed ulcerlike symptoms refractory to antisecretory therapy, an upper GI series showing an uncomplicated duodenal ulcer, a chest x-ray showing pneumoperitoneum from a perforated duodenal ulcer, gastric biopsy samples showing H. pylori organisms, and the approach to treatment and follow-up in patients with either complicated or uncomplicated duodenal or gastric ulcer. Tables list differential diagnoses of peptic ulcer disease, commonly used regimens to eradicate H. pylori, additional antimicrobial agents with activity against H. pylori, and FDA-approved antisecretory drugs for active peptic ulcer disease. This chapter contains 5 figures, 6 tables and 78 references.


2020 ◽  
Vol 20 (3) ◽  
pp. 1446-1451
Author(s):  
Emeka Ray-Offor ◽  
Kalanne Ada Opusunju

Background: Epidemiological studies on peptic ulcer disease (PUD) have shown a recent decrease in hospital admissions in Western countries. Objective: This paper aimed to study the current status and risk factors of PUD in a Nigerian metropolis. Methods: A cross-sectional study of symptomatic patients at upper gastrointestinal (GI) endoscopy diagnosed with PUD from February 2014 to September 2019 at a referral endoscopy facility in Port Harcourt, Niger delta region of Nigeria. The variables studied included demographics, symptoms and duration, blood group, chronic non-steroidal anti-inflammatory (NSAID) use, smoking, endoscopic and histology findings. Statistical analysis was performed using SPSS version 20. Results: A total of 434 upper GI endoscopies were performed during the study period with thirty-one diagnosis of PUD made. The mean age of gastric ulcer (GU) and duodenal ulcer (DU) cases were 54.4 ± 20.2yrs and 48.1 ± 14.5yrs respectively (p = 0.367). GU to DU ratio was 1.4:1. H. pylori infection, chronic NSAID use and blood group O were seen in 7(22.5%), 8(25.8%) and 18(72.0%) respectively. Major indication in 21(67.7%) cases was gastrointestinal bleeding. Conclusion: There is a low diagnostic rate of PUD (6.7%) with pre-pyloric antral gastric ulcers as most common type and multifactorial aetiology. Keywords: Gastric ulcer; duodenal ulcer; endoscopy.


1982 ◽  
Vol 63 (3) ◽  
pp. 21-23
Author(s):  
V. F. Bogoyavlenskiy ◽  
A. G. Oparin ◽  
R. M. Gazizov ◽  
T. I. Rupasova

In 60 healthy individuals and 85 patients with gastric ulcer and duodenal ulcer, the state of microcirculation of the conjunctiva of the eye and the level of glycoproteins in the gastric juice were studied. It has been shown that one of the reasons leading to a decrease in the level of mucins in gastric juice may be mucosal hypoxia caused by impaired microcirculation.


Author(s):  
O. V. Demydas

Objective — to analyze clinical neurological manifestations in patients suffering from peptic ulcer disease in the acute phase and in remission, based on the findings of a comprehensive clinical neurological, neuropsychological and paraclinical study. Methods and subjects.  84 patients suffering from PUD were comprehensively examined while in the acute phase of the disease and then all 84 were reexamined while in remission. The age range of the patients was from 25 to 60 years. The average age of the patient was 39.90 ± 1.29 years. The examined individuals were destributed into two groups based on whether they presented symptoms of an acute phase or remission of the peptic ulcer disease. The comprehensive examination included: interview and complaint analysis, neurological examination focused on the state of the autonomic nervous system, study of the neuropsychological differences (the trait and state anxiety levels monitoring based on the Spielberg‑Khanin scale, depressive state evaluation using Beck Depression Inventory, self‑perceived health assessment, mood and activity monitoring using the SAN questionnaire, cognitive impairment evaluation using the MMSE scale, assessment of the refocusing speeds and performance distribution using Schulte tables), as well as lab tests and procedures. Results. Most often, subjects complained of headache (74 (88.0 %) in the acute stage and 37 (44.0 %) in remission). The second most common was a complaint of pain in the thoracic spine (69 (82.1 %) and 35 (41.6 %), respectively). Complaints of dizziness, pain in the heart, palpitations, «interruptions» in the heart, paresthesia were often recorded. In 11 (12.4 %) patients with duodenal ulcer in the acute stage experienced episodes of syncopal state, while in the remission stage they were absent. Complaints that indicated the presence of psychoemotional disorders were anxiety, decreased memory and attention, and sleep disturbances. In patients with duodenal ulcer disease we revealed lesions of the central and peripheral nervous system. Central nervous system disorders were manifested in the form of vestibulo‑cerebellar syndrome (in 30 (35.7 %) patients in the acute stage and in 14 (16.6 %) in the remission stage), extrapyramidal disorders (respectively in 10 (11.9 %) and 4 (4.76 %)) and signs of pyramidal dysfunction (37 (44.0 %) and 15 (17.8 %)). Clinical and neurological examination of the peripheral nervous system in 68 (80.9 %) patients with peptic ulcer in the acute stage and in 31 (36.9 %) in the remission stage revealed polyneuropathy syndrome of varying degrees. Signs of polyneuropathy were accompanied by complaints of disorders of the peripheral nervous system (45 (53.5 %) and 15 (17.8 %) cases, respectively). In 27.4 % of patients with peptic ulcer disease in the acute stage of the complaint were absent at all, and only a thorough neurological examination revealed signs of polyneuropathy. In 56 (66.6 %) patients with peptic ulcer disease in the acute stage and 28 (33.3 %) in the remission stage, the morbidity of paravertebral points in the lower thoracic spine was revealed. Conclusions. Having analyzed the data obtained through the interviews, as well as the neurological characteristics of patients with peptic ulcer disease of the duodenum in the acute phase and in remission it was concluded that most of the somatic complaints and neurological manifestations were common in both the acute phase and the remission of the disease. However, all of the identified neurological differences were significantly more common in the acute phase of the disease.  


1985 ◽  
Vol 66 (5) ◽  
pp. 377-377
Author(s):  
N. A. Cherkasova ◽  
H. S. Bikbulatova ◽  
V. N. Leonova

There were 26 patients with gastric ulcer and duodenal ulcer (17 boys, 9 girls) aged from 9 to 18 years under observation.


2021 ◽  
Vol 4 (5) ◽  
pp. 01-05
Author(s):  
Martynov Vladimir Leonidovich

The classic works of I.P. Pavlov shows strong communication mechanisms between the two most important life-supporting systems of the body - the nervous and the digestive. The role of the autonomic nervous system (ANS) in the occurrence of acute gastroduodenal erosions and ulcers has been proven [1]. The flow of sympathetic impulses causes an excessive release of mediators (catecholamines), which leads to disruption of tissue trophism. An important role in ulceration belongs to the parasympathetic nervous system.


Author(s):  
VAZHA GVANTSELADZE ◽  
NANA GNANTSELADZE

The aim of the study was to study the frequency and nature of episodes of heartburn and bloating in patients with duodenal and gastric ulcers in the Georgian population, considering the histomorphological and morphometric changes of the gastric mucosa and the parameters of gastric secretion. At the same time, we were interested in analyzing patients' anamnesis before being hospitalized for the last 2 months. The analysis of the material showed that incidence of heartburn episodes in the Georgian population is clearly higher in patients with peptic ulcer disease 12 - (79.9%) than in patients with gastric ulcer (9 - 31.9%). Episodes of heartburn in these patients are characterized not only by increasing of rate (more than 50 episodes), both day and night, but the intensity and duration (which is due to abnormal gastroesophageal reflux). This is a high risk for the occurrence of heartburn episodes. As for bloating, it was detected in patients with duodenal ulcer (11–26.2%), in gastric ulcer 11– (32.9%). The main pathogenetic aspects of heartburn episodes were found to be diffuse fundal glands hyperplasia and high acidity (duodenal ulcer and pyloric anterior ulcer). It was also found that a large percentage of patients were not treated properly, leading to impaired ability to work and changes in quality of life and disease progression.


2016 ◽  
pp. 138-142
Author(s):  
Yurii Gurzhenko ◽  
Vasyl Soroka

The aim of the research: evaluation of the peculiarities of anxiety in male patients with gastric ulcer and duodenal ulcer, which are sexual disorders. Materials and methods. The research is based on the generalization of the results of complex examination and treatment of 130 patients with peptic ulcer of duodenum and stomach in remission who have sexual disorders. The patients were divided into three groups: basic, comparative and referential. Was used C. Spielberger’s self-evaluation scale of situational and personal anxiety and M. Kurgan’s methodology. Results. It has been proven that the level of personal anxiety has a close correlation with the duration of peptic ulcer disease. Conclusion. The presence of peptic ulcer disease creates a certain basis for further psychological stress, similar to negative effect with the development of sexual disorders. Among the examined patients prevailed the somatized nature of depression.


PEDIATRICS ◽  
1988 ◽  
Vol 82 (3) ◽  
pp. 410-414
Author(s):  
Brendan Drumm ◽  
J. Marc Rhoads ◽  
David A. Stringer ◽  
Phillip M. Sherman ◽  
Lynda E. Ellis ◽  
...  

The records of all children with peptic ulcer disease at the Hospital for Sick Children were retrospectively evaluated, excluding neonates, throughout a 5-year period. Only cases with a definite ulcer crater identified either at endoscopy or at surgery were included. There were 36 patients, 20 boys and 16 girls. Duodenal ulcers were more common than gastric ulcers (2.8:1). Ages ranged from 3 months to 17 years, with a mean age of 10 years. Patients were reviewed with respect to etiology of peptic ulcer disease, age when first examined, initial symptoms, and clinical course. Patients were divided into two groups, those with primary (n = 19) and those with secondary (n = 17) peptic ulcer disease. All peptic ulcers in patients younger than 10 years of age were secondary in nature. Secondary ulcers occurred generally in association with a severe underlying illness (11/17), and many ulcers necessitated emergency surgery because of perforation and/or severe hemorrhage (8/17). None of these patients had chronic or recurrent symptoms. In contrast, in children with primary peptic ulcer disease, initial symptoms were more benign. Most patients had abdominal pain and only one required emergency surgery. Children with primary duodenal ulcer disease had a high incidence of recurrent symptoms (67%), however, with surgery for intractable disease necessitated in 40%. Single-contrast barium meals were found to be unreliable in establishing a diagnosis of peptic ulcer disease, particularly cases of gastric ulcer disease.


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