ascorbic-acid and Duodenal-Ulcer

Helicobacter pylori infection is now recognized to be an important acquired factor in the pathogenesis of duodenal ulcer disease. There is also an association between H pylori and the subsequent development of gastric cancer. The mechanism of the association between the infection and those disorders is incompletely understood but there is increasing evidence that H pylori-induced disturbances of gastric function play a pivotal role. In this article we review the role of H pylori infection in the pathophysiology of these important upper gastrointestinal diseases.

Topics: Ascorbic Acid; Duodenal Ulcer; Gastric Acid; Gastrins; Helicobacter Infections; Helicobacter pylori; Humans; Stomach Neoplasms

Topics: Ascorbic Acid; Duodenal Ulcer; Gastritis; Helicobacter Infections; Helicobacter pylori; Humans; Incidence; Stomach Neoplasms; Virulence

The mechanisms of aspirin induced gastroduodenal injury are not fully understood. Aspirin induces the release of reactive oxygen metabolites in animal models, which may contribute to mucosal injury.. To investigate the effects of aspirin administered with placebo or antioxidants on gastric mucosal reactive oxygen metabolite release and gastroduodenal injury in human volunteers.. Fourteen healthy volunteers participated in the study (seven male; mean age 27 years, range 20-40).. In a double blind, randomised, crossover study, volunteers received aspirin 900 mg twice daily and either placebo, allopurinol 100 mg twice daily, sulphasalazine 1 g twice daily or vitamin C 1 g twice daily for three days. Injury was assessed endoscopically and by quantifying mucosal reactive oxygen metabolite release by measuring chemiluminescence before and after each treatment. The effect on prostanoids was determined by measuring ex vivo antral prostaglandin E2 (PGE2) synthesis and serum thromboxane B2 (TXB2).. No drug reduced any parameter of gastric injury but vitamin C reduced duodenal injury assessed by Lanza score (p < 0.005). Chemiluminescence increased after aspirin both with placebo (p < 0.05) and vitamin C (p < 0.05). Post-treatment chemiluminescence was lower in subjects taking allopurinol (p < 0.05) or sulphasalazine (p < 0.005) than in those taking placebo with aspirin.. In this study, aspirin induced gastric injury was associated with reactive oxygen metabolite release. This was reduced by sulphasalazine and allopurinol, although macroscopic injury was not affected. Vitamin C, however, was shown to have a previously unrecognised protective effect against aspirin induced duodenal injury.

Topics: Adult; Allopurinol; Anti-Inflammatory Agents, Non-Steroidal; Anti-Ulcer Agents; Antioxidants; Ascorbic Acid; Aspirin; Cross-Over Studies; Double-Blind Method; Duodenal Ulcer; Duodenum; Female; Gastric Mucosa; Humans; Male; Prostaglandins E; Reactive Oxygen Species; Sulfasalazine

Ascorbic acid, the reduced form of vitamin C, may protect against gastric cancer and is secreted by the normal stomach. Secretion is impaired in Helicobacter pylori (H pylori) associated chronic gastritis. This study examined if eradication of H pylori improves gastric juice ascorbate values. Fasting gastric juice and plasma samples were collected at endoscopy from patients participating in trials of H pylori eradication for duodenal ulcer disease and intestinal metaplasia before and up to 15 months after attempted eradication. Ascorbic acid and total vitamin C concentrations were determined by high performance liquid chromatography. In 12 patients in whom H pylori was successfully eradicated gastric juice ascorbate and total vitamin C concentrations and the ratio of juice to plasma vitamin C rose after treatment. Analysis after treatment suggested that the rise was greatest in patients with high final plasma vitamin C concentrations, even though these did not change with treatment. By contrast, in 22 patients in whom H pylori eradication was unsuccessful there were no significant changes in juice or plasma concentrations after treatment. It is concluded that successful eradication of H pylori improves secretion of vitamin C into gastric juice. It is speculated that this increases protection against gastric cancer.

Topics: Aged; Ampicillin; Anti-Ulcer Agents; Ascorbic Acid; Drug Therapy, Combination; Duodenal Ulcer; Fasting; Follow-Up Studies; Gastric Juice; Helicobacter Infections; Helicobacter pylori; Humans; Intestines; Male; Metaplasia; Metronidazole; Organometallic Compounds; Oxytetracycline; Treatment Outcome

Topics: Antacids; Ascorbic Acid; Bismuth; Diet Therapy; Duodenal Ulcer; Estrogens; Glycyrrhiza; Histidine; Humans; Methods; Pain; Parasympatholytics; Placebos; Plants, Medicinal; Rest; Smoking

Topics: Anemia; Ascorbic Acid; Diagnosis, Differential; Duodenal Ulcer; Gastrointestinal Hemorrhage; Humans; Male; Middle Aged; Scurvy; Treatment Outcome

Prevalence of peptic ulcer disease has been associated to diet. Some dietary factors seem to have bactericidal effect which may modify the risk of peptic ulcer disease. The objective was to analyze associations between dietary habits and peptic ulcers.. A cross sectional population study.. One thousand, one hundred and thirty-five subjects out of 11700 randomly invited men and women, aged 46-67 y, participating in a diet and disease study during 1991-1993. The study population comprised of 764 cases with reported peptic ulcer, 142 with dyspeptic symptoms and 229 randomly selected controls.. X-ray examinations and endoscopies were reviewed and 332 out of 764 peptic ulcer cases were verified. Mean daily intake of foods and nutrients were assessed with a combined 7d menu book and a quantitative food frequency questionnaire, including dietary supplements.. Subjects with verified ulcer had lower intake of fermented milk products and vegetables and higher intake of milk, meat and bread than controls. Intake of total fat, saturated and monounsaturated fatty acids and linolenic acid were higher in the ulcer group. Higher intake of fermented milk products, by quintiles showed a decreased ulcer risk; odds ratio 0.82 (0.71-40.95), adjusted for covariates below. Higher intake of milk, by quintiles, was associated with an increased risk of ulcer; odds ratio 1.17 (1.03-1.32). Smoking, foreign ethnicity and being unmarried or divorced were covariates associated to ulcer.. This study indicates the multifactorial etiology of peptic ulcer including dietary factors. High intake of fermented milk products was associated with decreased risk for ulcer, whereas increased risk was noted for high milk intake.

Topics: Aged; Animals; Ascorbic Acid; Cross-Sectional Studies; Diet; Dietary Carbohydrates; Dietary Fats; Duodenal Ulcer; Energy Intake; Female; Fermentation; Humans; Life Style; Male; Middle Aged; Milk; Risk Factors; Stomach Ulcer; Sweden

Duodenal ulceration in rats was induced by a single subcutaneous injection of cysteamine at doses of 7, 28, 42 and 65 mg/100 g body weight 24 h before killing. Duodenal ulceration induced by cysteamine was dose-dependent. However, at 65 mg/100 g body weight, 5 of 6 animals died within 24 h. The concentrations of reduced glutathione (GSH) and ascorbic acid were measured in the duodenal homogenates of cysteamine-treated rats. The ulcerogen, at doses of 28 and 42 mg/100 g body weight, significantly reduced the GSH concentration. At a dose of 28 mg/100 g body weight, however, it did not significantly affect the duodenal ascorbic acid concentration. Pretreatment of rats with daily intramuscular injections of cysteine at 25, 50 and 100 mg/kg or ascorbic acid at 50, 100 and 200 mg/kg for 7 days had no significant effect on the duodenal ulceration produced by cysteamine (28 mg/100 g body weight), although each pretreatment significantly raised the duodenal concentrations of GSH and ascorbic acid respectively, in control rats, and to a lesser extent in cysteamine-treated animals.

Topics: Animals; Ascorbic Acid; Cysteamine; Cysteine; Dose-Response Relationship, Drug; Duodenal Ulcer; Duodenum; Female; Glutathione; Premedication; Rats; Rats, Inbred Strains; Time Factors

Fasting gastric juice pH and concentrations of vitamin C in gastric aspirate and plasma were measured in 73 patients undergoing endoscopy. Vitamin C concentrations were significantly lower in those with hypochlorhydria (pH greater than 4; n = 23) compared with those with pH less than or equal to 4 (p less than 0.005) and there was a significant correlation between gastric juice and plasma concentrations (p = 0.002). Patients with normal endoscopic findings had significantly higher intragastric concentrations of vitamin C than those with gastric cancer (p less than 0.001), pernicious anaemia (p less than 0.005), gastric ulcer (p less than 0.01), duodenal ulcer (p less than 0.05), or after gastric surgery (p less than 0.01). There was a strong trend (0.05 less than p less than 0.1) towards lower intragastric concentrations of vitamin C in patients with chronic atrophic gastritis. In vitro, vitamin C concentrations remained stable in acidic but fell significantly over 24 hours in alkaline gastric aspirate. Gastric secretory studies in five volunteers showed that vitamin C concentrations increased significantly after intramuscular pentagastrin. These findings suggest that the low fasting levels of vitamin C in hypochlorhydric gastric juice may be caused by chemical instability and that vitamin C may be secreted by the human stomach.

Topics: Adult; Aged; Aged, 80 and over; Anemia, Pernicious; Ascorbic Acid; Diet; Duodenal Ulcer; Female; Gastrectomy; Gastric Acidity Determination; Gastric Juice; Humans; Male; Middle Aged; Stomach Diseases; Stomach Neoplasms; Stomach Ulcer

Ascorbic acid and ferrous sulfate were given to peptic ulcer patients (C-Fe therapy). In gastric ulcer patients, the healing index of the C-Fe therapy group was significantly higher than that of controls, but in duodenal ulcer patients, no significant difference was observed between the healing index of the C-Fe therapy group and that of controls. According to these results, it was concluded that C-Fe therapy was effective in healing gastric ulcers and that the cause of duodenal ulcers might depend more on aggressive factors than that of gastric ulcers.

Topics: Adult; Aged; Ascorbic Acid; Drug Evaluation; Drug Therapy, Combination; Duodenal Ulcer; Ferrous Compounds; Humans; Iron; Middle Aged; Stomach Ulcer

Topics: Adolescent; Adult; Aged; Ascorbic Acid; Chronic Disease; Duodenal Ulcer; Female; Humans; Male; Middle Aged; Stomach Ulcer

Topics: Acute Disease; Ascorbic Acid; Blood Transfusion; Diet; Diet Therapy; Duodenal Ulcer; Endoscopy; Esophageal and Gastric Varices; Gastritis; Gastrointestinal Hemorrhage; Hematemesis; Hernia, Diaphragmatic; Humans; Melena; Myocardial Infarction; Peptic Ulcer Hemorrhage; Radiography; Stomach Neoplasms; Vagotomy; Vitamin K

Topics: Ascorbic Acid; Aspirin; Asthma; Calcium; Citrates; Coronary Disease; Depression, Chemical; Diabetes Mellitus; Duodenal Ulcer; Dwarfism, Pituitary; Emphysema; Facial Paralysis; Gluconates; Histamine H1 Antagonists; Humans; Hypertension; Hyperthyroidism; Kidney Calculi; Liver Diseases, Parasitic; Magnesium; Oxalates; Phosphates; Pyridoxine; Schistosomiasis; Stimulation, Chemical; Terpenes; Tuberculosis, Pulmonary

Topics: Ascorbic Acid; Colitis, Ulcerative; Duodenal Ulcer; Gastrointestinal Diseases; Hernia, Diaphragmatic; Humans; Leukocytes; Liver Cirrhosis

Topics: Ascorbic Acid; Duodenal Diseases; Duodenal Ulcer; Female; Humans; Leukocytes; Male

Topics: Adult; Afibrinogenemia; Aminocaproates; Ascorbic Acid; Blood Coagulation Tests; Duodenal Ulcer; Fibrinogen; Fibrinolysis; Gastrectomy; Gastrointestinal Hemorrhage; Humans; Male; Rutin; Vitamin K

Topics: Ascorbic Acid; Carbohydrate Metabolism; Duodenal Ulcer; Humans; Niacin; Nicotinic Acids; Peptic Ulcer; Vitamin A