ascorbic-acid and Gastrointestinal-Hemorrhage

Henoch-Schönlein purpura (HSP) is an extremely rare condition in patients with pulmonary tuberculosis, with only a few reported cases. Compared to patients with typical clinical symptoms, it is difficult to make a definitive diagnosis when HSP presents as an initial manifestation in pulmonary tuberculosis patients. Herein, a case of pulmonary tuberculosis that showed HSP at first was reported, and the related literatures were reviewed.. A 24-year-old man presented with palpable purpura on the extremities, accompanied by abdominal pain, bloody stools, and knee pain.. The patient was diagnosed with pulmonary tuberculosis based on the results of interferon gamma release assays, purified protein derivative test, and computed tomography.. The patient was treated with vitamin C and chlorpheniramine for 2 weeks, and the above-mentioned symptoms were relieved. However, 3 weeks later, the purpura recurred with high-grade fever and chest pain during the inspiratory phase. The patient was then treated with anti-tuberculosis drugs, and the purpura as well as the high fever disappeared.. The patient recovered well and remained free of symptoms during the follow-up examination.. Pulmonary tuberculosis presenting with HSP as an initial manifestation is not common. Therefore, it is difficult to clinically diagnose and treat this disease. When an adult patient shows HSP, it is important to consider the possibility of tuberculosis to avoid misdiagnosis and delayed treatment.

Topics: Abdominal Pain; Aftercare; Antitubercular Agents; Ascorbic Acid; Chlorpheniramine; Diagnosis, Differential; Fever; Gastrointestinal Hemorrhage; Histamine H1 Antagonists; Humans; IgA Vasculitis; Interferon-gamma Release Tests; Male; Treatment Outcome; Tuberculin; Tuberculosis, Pulmonary; Vitamins; Young Adult

Glucose and ascorbate used for endoscopic hemostasis metabolic preventive to prevent recurrent ulcer bleeding. Unacceptable joint use in endohemostasis ascorbate and hydrogen peroxide.

Topics: Anti-Infective Agents, Local; Antioxidants; Ascorbic Acid; Endoscopy, Gastrointestinal; Gastrointestinal Hemorrhage; Glucose; Hemostasis, Endoscopic; Humans; Hydrogen Peroxide; Stomach Ulcer; Sweetening Agents

The most frequently reported adverse events associated with acetylsalicylic acid intake are minor gastrointestinal complaints. Galenic modifications, such as buffered formulations with or without ascorbic acid, may improve the benefit-risk ratio by decreasing the local mucosal side-effects of acetylsalicylic acid.. To assess endoscopically-proven gastrointestinal lesions and the amount of gastric microbleeding of four different buffered and plain acetylsalicylic acid formulations, one containing paracetamol.. A randomized, four-fold cross-over study was performed in 17 healthy subjects who underwent serial oesophago-gastro-duodenoscopy before and after each course of 4-day dosing. Gastric aspirates were collected for the determination of haemoglobin concentrations to detect microbleeding.. Buffered acetylsalicylic acid plus ascorbic acid yielded the lowest Lanza score, the lowest increase in the number of mucosal petechiae and the lowest increase in the amount of gastric microbleeding. Subjects receiving acetylsalicylic acid plus paracetamol plus caffeine showed the highest Lanza score of all treatments, and a considerably greater sum of petechiae in the oesophagus, stomach and duodenum compared with those receiving buffered acetylsalicylic acid plus ascorbic acid.. The trial confirms that buffering of acetylsalicylic acid improves local gastric tolerability. Acetylsalicylic acid in combination with ascorbic acid shows significantly fewer gastric lesions and the lowest increase in gastric microbleeding compared with the other tested formulations.

Topics: Adult; Anti-Inflammatory Agents, Non-Steroidal; Antioxidants; Ascorbic Acid; Aspirin; Cross-Over Studies; Female; Gastric Mucosa; Gastrointestinal Hemorrhage; Humans; Male; Prospective Studies; Risk Factors; Stomach Diseases

Vitamin C is an essential dietary nutrient important for collagen synthesis, including within the gastrointestinal tract.. We aimed to document the prevalence of Vitamin C deficiency (VCD) in patients who present with upper gastrointestinal bleeding (UGIB) and its association with clinical outcomes.. We conducted a prospective cohort study of patients presenting with UGIB. Fasting Vitamin C levels were collected at admission. Primary outcomes were the prevalence of VCD (Vitamin C level <23 μmol/L, severe VCD < 12 μmol/L) and a composite outcome of adverse events, stratified by VCD status. Secondary outcomes were prolonged hospitalisation and the need for ICU admission.. A total of 227 patients were included (mean age 64.5 years, males 63.9%). VCD was identified in 74 (32.6%) and severe deficiency in 32 (14.1%) patients. VCD was associated with a higher composite endpoint of AE (45.9% vs 24.8%, p < 0.01), higher in-hospital mortality (9.5% vs 1.3%, p < 0.01), increased prolonged admissions (62.2% versus 47.1%, p = 0.03) and increased rebleeding (17.6% vs 7.8%, p = 0.03), compared with patients with normal Vitamin C levels. Multivariate logistic regression models showed that VCD was independently associated with the composite endpoint of AE.. VCD is highly prevalent in patients with UGIB and associated with poorer outcomes, including higher mortality, rebleeding and length of stay. Interventional studies are required to determine the impact of early Vitamin C supplementation on clinical outcomes.

Topics: Ascorbic Acid; Ascorbic Acid Deficiency; Gastrointestinal Hemorrhage; Humans; Male; Middle Aged; Prevalence; Prognosis; Prospective Studies

A man in his 50s with dialysis-dependent end-stage renal disease, several weeks history of progressive skin bruising and acute-onset gastrointestinal bleeding presented to the emergency department following a syncopal event during routine haemodialysis owing to profound hypotension. He was found to have a severe normocytic, normochromic anaemia requiring several blood transfusions. He followed a diet lacking fruits and vegetables and stopped taking renal multivitamins. All parameters of coagulation were unremarkable, but serum vitamin C level was undetectable, supporting a diagnosis of scurvy. Although typically associated with individuals who are at risk of malnourishment, such as those with alcohol use disorder, malabsorption, and those who experience homelessness, scurvy should be considered in patients receiving renal replacement therapy as vitamin C is removed during haemodialysis.

Topics: Anemia; Ascorbic Acid; Gastrointestinal Hemorrhage; Hematoma; Humans; Male; Renal Dialysis; Scurvy; Vitamins

The purpose of this study was to investigate the effect of vitamin C combined with growth inhibitors on serum miR-130a, nitric oxide (NO), and hemostasis in the treatment of upper gastrointestinal bleeding (UGIB) in cirrhosis. Eighty patients with cirrhosis UGIB treated in our hospital from March 2021 to March 2022 were selected and divided into two groups using the random number table method. The control group received growth inhibitor treatment, while the observation group was given vitamin C combined with growth inhibitor treatment for 3 d. The hemostatic effect, serum laboratory indexes (miR-130a, NO), liver function indexes (aspartate aminotransferase (AST), alanine aminotransferase (ALT)), adverse effects, and 24 h hemostasis rate were compared between the two groups. The hemostasis time in the observation group was shorter than that in the control group, and the blood transfusion volume was lower than that in the control group. There was no statistical difference regarding the portal blood flow, miR-130a, NO, AST, and ALT indexes between the two groups before treatment. After treatment, the portal blood flow, miR-130a, NO, AST, and ALT indexes in both groups were lower than those before treatment, and all of them were lower in the observation group than in the control group. Adverse reactions showed no significant difference between the two groups of patients with cirrhosis UGIB,, while the 24 h hemostasis rate in the observation group (97.50%) was significantly higher than that in the control group (77.50%). Vitamin C combined with growth inhibitor was effective in the treatment of cirrhotic UGIB, which could effectively shorten the hemostasis time, reduce the transfusion volume and portal blood flow, and improve miR-130a, NO, and liver function levels of patients, with higher safety, and is worthy of clinical promotion.

Topics: Ascorbic Acid; Gastrointestinal Hemorrhage; Growth Inhibitors; Humans; Liver Cirrhosis; MicroRNAs

Since ancient times, scurvy has been considered one of the most fearsome nutritional deficiency diseases. In modern developed countries, this condition has become very rare and is only occasionally encountered, especially in the pediatric population. Underlying medical conditions, such as neuropsychiatric disorders, anorexia nervosa, celiac disease, Crohn disease, hemodialysis, and severe allergies to food products may enhance the risk of developing scurvy.. We report the case of an otherwise healthy 3-year-old white boy who developed scurvy due to a selective restrictive diet derived from his refusal to try new food. He presented to our clinic with asthenia and refusal to walk. During hospitalization he developed severe anemia and hematochezia. A diagnosis of scurvy was assessed on the basis of nutritional history, clinical features, radiographic findings, and laboratory findings. Supplementation of ascorbic acid enabled a prompt resolution of symptoms.. Scurvy is caused by vitamin C deficiency. Cutaneous bleeding, mucosal bleeding, and anemia represent typical manifestations of the disease. These symptoms are directly connected to ascorbic acid involvement in collagen biosynthesis. Some radiographic findings can be useful for the diagnosis. Treatment aims to normalize serum levels of vitamin C in order to counteract the deprivation symptoms. The present case report demonstrates that scurvy may sporadically occur in pediatric patients, even in individuals with no predisposing medical conditions and/or potential risk factors.

Topics: Anemia; Ascorbic Acid; Asthenia; Child Nutritional Physiological Phenomena; Child, Preschool; Diet; Gastrointestinal Hemorrhage; Humans; Male; Nutritional Status; Risk Factors; Scurvy; Vitamins

In this study we investigated the effect of free heme, the local level of which was increased by bleeding, on the intestinal barrier function, using human epithelial colorectal adenocarcinoma cells (Caco-2). Our results show that the addition of hemin to the culture medium markedly disrupted the barrier function, which was significantly improved by glutamine supplementation. Although hemin treatment caused the increased expression of heme oxygenase (HO)-1, the inhibition of HO activity resulted in the aggravation of hemin-induced barrier dysfunction. Up-regulation of HO-1 by pretreatment with a low concentration of hemin almost completely prevented hemin-induced barrier dysfunction. Taken together, these observations indicate that an abnormally high level of intracellular free heme causes barrier dysfunction, probably through the modulation of proteins forming tight junctions.

Topics: Ascorbic Acid; Caco-2 Cells; Gastrointestinal Hemorrhage; Glutamine; Heme Oxygenase-1; Hemin; Humans; Intestinal Mucosa; Malondialdehyde; Metalloporphyrins

Topics: Anemia; Ascorbic Acid; Colonic Diseases; Deglutition Disorders; Ecchymosis; Endoscopy, Gastrointestinal; Female; Gastrointestinal Hemorrhage; Humans; Ileal Diseases; Middle Aged; Rectum; Scurvy; Stomach Diseases

While bone marrow or stem cell transplantation can rescue bone marrow aplasia in patients accidentally exposed to a lethal radiation dose, radiation-induced irreversible gastrointestinal damage (GI syndrome) is fatal. We investigated the effects of ascorbic acid on radiation-induced GI syndrome in mice. Ascorbic acid (150 mg/kg/day) was orally administered to mice for 3 days, and then the mice underwent whole body irradiation (WBI). Bone marrow transplantation (BMT) 24 h after irradiation rescued mice receiving a WBI dose of less than 12 Gy. No mice receiving 14 Gy-WBI survived, because of radiation-induced GI syndrome, even if they received BMT. However, pretreatment with ascorbic acid significantly suppressed radiation-induced DNA damage in the crypt cells and prevented denudation of intestinal mucosa; therefore, ascorbic acid in combination with BMT rescued mice after 14 Gy-WBI. DNA microarray analysis demonstrated that irradiation up-regulated expressions of apoptosis-related genes in the small intestine, including those related to the caspase-9-mediated intrinsic pathway as well as the caspase-8-mediated extrinsic pathway, and down-regulated expressions of these genes in ascorbic acid-pretreated mice. Thus, pretreatment with ascorbic acid may effectively prevent radiation-induced GI syndrome.

Topics: Animals; Apoptosis; Apoptosis Regulatory Proteins; Ascorbic Acid; Bone Marrow; Bone Marrow Transplantation; Caspases; Diarrhea; DNA Damage; Drug Evaluation, Preclinical; Free Radicals; Gastrointestinal Hemorrhage; Gene Expression Regulation; Intestinal Mucosa; Intestine, Small; Male; Mice; Mice, Inbred C57BL; Premedication; Radiation Chimera; Radiation Injuries, Experimental; Radiation-Protective Agents; Whole-Body Irradiation

Topics: Adult; Arthralgia; Ascorbic Acid; Ascorbic Acid Deficiency; Edema; Epistaxis; Gastrointestinal Hemorrhage; Humans; Knee Joint; Male; Pigmentation Disorders; Scurvy

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

The interaction between Helicobacter pylori (H. pylori) and nonsteroidal anti-inflammatory drugs (NSAIDs) such as acetylsalicylic acid is still controversial. This study was designed to compare the effect of acetylsalicylic acid and vitamin C-releasing acetylsalicylic acid on the gastric mucosal damage and microbleeding before and after eradication of H. pylori in 10 young healthy volunteers. Acetylsalicylic acid induced significantly more gastric lesions and higher microbleeding than acetylsalicylic acid-vitamin C. After successful H. pylori eradication therapy, acetylsalicylic acid induced significantly higher mucosal lesions and microbleeding than before eradication. In contrast, after acetylsalicylic acid-vitamin C, gastric lesion index was significantly lower and eradication therapy failed to aggravate it. All H. pylori-positive subjects showed significant up-regulation of antioxidant enzyme (superoxide dismutase, catalase, glutathione peroxidase). Plain acetylsalicylic acid stronger than acetylsalicylic acid-vitamin C reduced gastric gene expression of these antioxidant enzymes. H. pylori eradication significantly decreased expression of these enzymes and this was further enhanced by plain acetylsalicylic acid, but not acetylsalicylic acid-vitamin C. Under plain acetylsalicylic acid therapy, the expression of proinflammatory cytokines was increased before and after eradication of H. pylori. We conclude that vitamin C combined with acetylsalicylic acid, unlike plain acetylsalicylic acid without vitamin C, protects gastric mucosa in man probably due the attenuation of oxidative stress and proinflammatory cytokines.

Topics: Adolescent; Adult; Anti-Inflammatory Agents, Non-Steroidal; Ascorbic Acid; Aspirin; Blotting, Western; Catalase; Cytokines; Female; Gastric Mucosa; Gastrointestinal Hemorrhage; Gene Expression Regulation, Enzymologic; Glutathione Peroxidase; Helicobacter Infections; Humans; Male; NF-kappa B; Nitric Oxide Synthase; Nitric Oxide Synthase Type II; Reverse Transcriptase Polymerase Chain Reaction; Stomach Ulcer; Superoxide Dismutase

Twenty male triathletes (R 18-39 mean = 27.5 yrs) provided blood and faecal samples during intense training, pre-race taper and post-competition. All answered a closed-end questionnaire on intake of aspirin, NSAIDS, Vitamin C, iron and red meat. History of GIT blood loss and training distances were also obtained. Blood samples were taken on three occasions and analysed for Haemoglobin(Hb) and Serum Ferritin concentrations. Faecal specimens were collected on five occasions and assessed for blood loss using Haemoccult II and Monohaem (a monoclonal antibody test specific for human haemoglobin). Mean Hb and 95% confidence intervals at the three stages were 14.53gm/l (13.95-15.10), 14.9gm/l (14.46-15.34), 14.57gm/l (14.18-14.97) respectively. There was a small, but statistically significant, increase in Hb during the pre-race taper period (paired t = 2.65, p < 0.05), and a non-significant drop in Hb post-event (paired t = 1.89, p = 0.075). Mean ferritin, MCV and haematocrit values did not significantly change. Eighty percent of the group exhibited faecal blood loss on one or more of the tests used. There were significant increases in both Haemoccult (chi 2 = 5.44, p < 0.04) and Monohaem (chi 2 = 7.36 p < 0.02). Regression analysis demonstrated a significant relationship between training Hb and total training intensity (R = -0.61, F1,l5 = 8.98, p < 0.009) and training run intensity (R = -0.55, F1,l5 = 6.17, p < 0.026), as estimated using Coopers aerobic points system. These results confirm that GIT blood loss is common in endurance athletes, and appears to be related to exercise intensity. The possible mechanisms of blood loss are discussed.

Topics: Adult; Anemia; Anti-Inflammatory Agents, Non-Steroidal; Ascorbic Acid; Aspirin; Bicycling; Erythrocyte Indices; Feces; Ferritins; Gastrointestinal Hemorrhage; Hematocrit; Hemoglobins; Humans; Iron; Male; Meat; Physical Endurance; Running; Sports; Swimming

To determine the ability of the Hemoccult and Gastroccult tests (SmithKline Diagnostics) to detect blood in vitro in whole-bowel irrigation (WBI) solution.. One tablet of ferrous gluconate 324 mg, ferrous sulfate 325 mg, or ascorbic acid 500 mg; or one Materna prenatal vitamin tablet (Lederle Laboratories) was dissolved in 30 mL of Colyte. Colyte alone and each test solution were tested with Hemoccult and Gastroccult slides, then retested at pH values of 3 and 8. Fresh solutions were then spiked with blood and tested with Gastroccult slides. Materna and ascorbic acid solutions were spiked with blood, then tested with Hemoccult slides.. Positive results were difficult to detect on Gastroccult slides. Hemoccult slides were falsely positive for solutions containing only iron and falsely negative for blood-spiked samples containing ascorbic acid.. Both the Hemoccult and Gastroccult tests may be unreliable in detecting GI bleeding in cases of iron overdose treated with WBI.

Topics: Ascorbic Acid; Delayed-Action Preparations; Drug Overdose; False Negative Reactions; False Positive Reactions; Ferrous Compounds; Gastrointestinal Hemorrhage; Humans; Iron; Occult Blood

The rat gastric mucosa, superfused with 0.1 N HCl, was investigated following 15 min of hemorrhagic shock and 30 min of retransfusion after pretreatment with ascorbate (1 mg/100 g b.w. or 5 mg/100 g b.w.). The size of the ischemic areas and the amount of mucosal bleeding using 51Cr labeling of red blood cells were assessed. Ischemic areas developed during shock. Following retransfusion, bleedings occurred at the border zones between ischemic and surrounding circulated areas. Ascorbate in both doses protected the gastric mucosa by reducing the amount of bleeding following 30 min of retransfusion as well as by reducing the area of ischemia 5 min after retransfusion.

Topics: Animals; Ascorbic Acid; Gastric Mucosa; Gastrointestinal Hemorrhage; Male; Rats; Rats, Sprague-Dawley; Reperfusion; Reperfusion Injury; Shock, Hemorrhagic

The authors studied the variations of ascorbic acid levels in white blood cells and plasma by Denson-Bowers' method in 20 normal individuals (Group I) and 36 schistosoma patients with hepatosplenic disease with and without gastrointestinal haemorrhage (Groups II and III, including 18 patients each). Having submitted the results to statistical analysis with a probability rate of 95%, the authors concluded that, while no significant difference could be seen between Groups I, II and III in ascorbic acid levels in white blood cells, there was a significant decrease in plasma ascorbic acid levels of Group III as compared with Groups I and II.

Topics: Adolescent; Adult; Ascorbic Acid; Brazil; Female; Gastrointestinal Hemorrhage; Hepatomegaly; Humans; Leukocytes; Male; Middle Aged; Schistosoma mansoni; Schistosomiasis; Splenomegaly

The effects of varying levels of dietary vitamin C on the incidence of aspirin-induced gastric hemorrhagic lesions were studied in young, male rats. Rats fed diets containing either 20, 40, or 60 mg of L-ascorbic acid per gram of diet did not exhibit focal gastric lesions. Administering a single oral dose of aspirin (30 mg aspirin/100 g of body weight) to rats fed control diets produced gastric lesions. When the rats were given aspirin plus a diet containing either 40 or 60 mg ascorbic acid per gram of diet, there was a significant increase in number of gastric lesions. Since vitamin C and aspirin seem to act synergistically in producing hemorrhagic lesions in the stomach, it is recommended that all individuals taking megadoses of vitamin C be cautioned against taking aspirin concurrently.

Topics: Animals; Ascorbic Acid; Aspirin; Dose-Response Relationship, Drug; Drug Synergism; Gastric Mucosa; Gastrointestinal Hemorrhage; Male; Rats

The complications of emergency surgery for acute upper gastro-intestinal haemorrhage in 95 patients were compared with those of surgery for non-bleeding benign peptic ulceration in 380 patients. There was a significantly higher number of senior surgeons performing emergency surgery for haemorrhage. There was a significantly higher mortality (10-5 %), wound dehiscence rate (12-6 %) and wound complication rate with re-bleeding (33-7 %) in the post-haemorrhage patients compared with the non-bleeding group (1-3, 1-8 and 11-6 % respectively). There was no significant difference in the incidence of chest infection in the two groups. Mortality and morbidity after haemorrhage were correlated directly with the amount of blood transfused before surgery. Rats were used to study the effect of the removal of 13 % of the blood volume, and its restoration after varying time intervals, upon subsequent wound healing. Abdominal wounds were tested at 7 days for breaking and bursting strength. There was no difference between the wound strength of the control animals and animals which had been bled for 4 minutes before wounding. A significant reduction of wound strength occurred in animals which had been bled for 30-60 minutes before wounding. Prolonged blood loss was associated with deficient wound healing even if blood loss was restored before the wounds were made. Stored blood may be deficient in a factor which is necessary for normal wound healing.

Topics: Adolescent; Adult; Age Factors; Aged; Animals; Ascorbic Acid; Blood Pressure; Blood Transfusion; Blood Volume; Female; Gastrointestinal Hemorrhage; Humans; Male; Middle Aged; Peptic Ulcer; Postoperative Complications; Rats; Shock, Hemorrhagic; Surgical Wound Dehiscence; Wound Healing

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: Adult; Alcoholic Intoxication; Ascorbic Acid; Ascorbic Acid Deficiency; Aspirin; Blood Cell Count; Capillary Fragility; Diet; Female; Gastrointestinal Hemorrhage; Humans; Kwashiorkor; Leukocytes; Male; Middle Aged; Peptic Ulcer Hemorrhage; Scurvy

Topics: Aged; Anemia, Hypochromic; Ascorbic Acid; Female; Gastrointestinal Hemorrhage; Hemoglobinometry; Humans; Infections; Infusions, Parenteral; Iron-Dextran Complex; 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; Flavonoids; Gastrointestinal Hemorrhage; Humans; Peptic Ulcer; Peptic Ulcer Hemorrhage; Vitamins