gastrins and ecabet

The remnant stomach after surgery for gastric cancer is at high risk for the metachronous development of multiple gastric cancers. Here, we report on eradication therapy of Helicobacter pylori in the remnant stomach, comparing the eradication rate with that in unoperated stomachs. We examined gross and histological changes after treatment.. Forty H. pylori-positive patients after distal gastrectomy were treated with proton pump inhibitor (PPI)-based dual and triple therapies. After eradication, histological changes were classified on the basis of the updated Sydney system.. The eradication rate in the remnant stomach was 70% (14 of 20) after dual therapy and 90% (18 of 20) after triple therapy, using per-protocol analysis, and these rates were comparable to the rates of 70% (186 of 264) and 88% (58 of 66), respectively, in nonsurgery patients. After eradication, three sites in the remnant stomach showed similar histological changes: significant decreases in inflammation and activity scores (P < 0.001) and no significant changes in glandular atrophy and intestinal metaplasia scores.. PPI-based therapy was as effective for H. pylori eradication in the remnant stomach as in the unoperated stomach, and eradication therapy resulted in a significant decrease in inflammatory cell infiltration of the mucosal layer.

Topics: 2-Pyridinylmethylsulfinylbenzimidazoles; Abietanes; Aged; Amoxicillin; Anti-Bacterial Agents; Anti-Infective Agents; Biomarkers; Biopsy; Drug Therapy, Combination; Endoscopy, Gastrointestinal; Female; Follow-Up Studies; Gastrectomy; Gastric Stump; Gastrins; Helicobacter Infections; Helicobacter pylori; Humans; Incidence; Lansoprazole; Male; Middle Aged; Omeprazole; Pepsinogen A; Pepsinogen C; Proton Pump Inhibitors; Proton Pumps; Randomized Controlled Trials as Topic; Severity of Illness Index; Time Factors; Treatment Outcome

Helicobacter pylori infection is common in patients with hyperplastic gastric polyps.. To study the effect of eradication of H. pylori on the clinical course of patients with hyperplastic gastric polyps.. Single-blind, randomized, controlled trial.. University-based gastroenterology outpatient clinic.. 35 patients with H. pylori infection and hyperplastic gastric polyps at least 3 mm in diameter.. Patients were randomly assigned to a treatment group (n = 17), which received a proton-pump inhibitor (omeprazole or lansoprazole), amoxicillin, and either clarithromycin or ecabet sodium, or to a control group (n = 18), which received no treatment.. Patients underwent endoscopy before enrollment and 12 to 15 months after the end of treatment. Serum gastrin levels and titers of IgG to H. pylori were measured.. In the treatment group, the polyps had disappeared by 3 to 15 months (average, 7.1 +/- 1.2 months) after the end of treatment in 12 of all 17 patients (71%) and in 12 of the 15 patients (80%) in whom H. pylori was eradicated. However, 12 to 15 months after the start of the study, no change in polyps or H. pylori status was seen in any controls (P < 0.001). Histologic findings of inflammation and activity, serum gastrin levels, and titers of IgG to H. pylori showed significant regression in the treatment group compared with the control group (P < 0.01).. Most hyperplastic polyps disappeared after eradication of H. pylori. Thus, eradication should be attempted before endoscopic removal is done in patients with hyperplastic gastric polyps and H. pylori infection.

Topics: 2-Pyridinylmethylsulfinylbenzimidazoles; Abietanes; Adult; Aged; Amoxicillin; Anti-Bacterial Agents; Clarithromycin; Diterpenes; Drug Therapy, Combination; Female; Gastrins; Helicobacter Infections; Helicobacter pylori; Humans; Hyperplasia; Immunoglobulin G; Lansoprazole; Male; Middle Aged; Omeprazole; Penicillins; Polyps; Proton Pump Inhibitors; Single-Blind Method; Statistics, Nonparametric; Stomach Neoplasms

Ecabet sodium (ecabet), a cytoprotective drug, produces an increase in mucosal blood flow. One of the gastrointestinal motility regulatory factors has been assumed to be the induction of changes in the levels of peptides (gastrin, somatostatin and motilin) in plasma. On the other hand, recently, capsaicinsensitive afferent nerves were shown to play an important role in gastric mucosal defensive mechanism. Capsaicin stimulates afferent nerves and enhances the release of calcitonin gene-related peptide (CGRP) and substance P in the stomach. We studied the effect of ecabet on human plasma gastrin-, somatostatin-, motilin-, CGRP- and substance P-like immunoreactive substance (IS) in healthy subjects. Ecabet sodium at a dose of 3.0 g, or placebo, was orally administered in five healthy males. The blood samples were taken before and at 20, 40, 60, 90, 120, 180 and 240 min after administration, subjected to extracting procedures, and submitted to a highly sensitive enzyme immunoassay system. Single administration of ecabet caused significant (P<0.05) increases in plasma CGRP-, substance P- and somatostatin-IS concentration compared with placebo. Ecabet significantly decreased plasma gastrin-IS levels compared with placebo. In this study, we hypothesized that ecabet might stimulate capsaicin-sensitive afferent nerves indirectly and improve mucosal blood flow; this might be a key mechanism underlying its gastroprotective action.

Topics: Abietanes; Adult; Calcitonin Gene-Related Peptide; Chromatography, High Pressure Liquid; Circadian Rhythm; Cytoprotection; Gastrins; Humans; Immunoenzyme Techniques; Male; Motilin; Somatostatin; Substance P