dinoprost and Dyspepsia

Nonsteroid anti-inflammatory drugs represent an important osteoarthritis (OA) therapy component, but also a leading cause of gastropathy: one of the most frequent and serious OA therapy complications. The aim of the present study was to study the influence of GI health in an OA population receiving either ginger or diclofenac.. Forty-three (43) patients with confirmed OA (knee and hip) were included in a randomized controlled study. A ginger group of 21 patients (17 women, 4 men) was given a specific ginger combination daily (340 mg EV.EXT 35 Zingiber officinalis extract) for 4 weeks. A diclofenac group (positive control) of 22 patients (18 women, 4 men) received 100 mg diclofenac daily for the same period. Both groups also received 1000 mg glucosamine daily. Gastrointestinal pain and dyspepsia were evaluated according to the severity of dyspepsia assessment (SODA) form. Patients also underwent esophagogastroduodenoscopy (EGDS) including biopsy before and after the treatment. Serum gastrin-17 levels, and stomach mucosa prostaglandins (PG) E1, E2, F2α, and 6-keto PGF1α (PGI2) levels were measured. Arthritic pain was evaluated using the visual analogue scale (VAS) on standing and moving.. The ginger group showed a slight but significantly lowered SODA pain and no change of SODA dyspepsia. EGDS showed significantly increased levels of PGE1, PGE2, and PGF2α in the stomach mucosa. This rise in gastric mucosa PG levels correlated with an increase in serum gastrin-17. On the other hand, the diclofenac group showed increased SODA pain and dyspepsia values with a corresponding significant decrease of stomach mucosa prostaglandins and general negative stomach mucosa degeneration. Both groups showed a relevant and significantly lowered VAS pain both on standing and moving.. The ginger combination is as effective as diclofenac but safer in treating OA, being without effect on the stomach mucosa. The increased mucosal PGs synthesis in the ginger group supports an increased mucosa-protective potential. VAS; visual analogue scale, 0-100 mm.

Topics: Abdominal Pain; Alprostadil; Anti-Inflammatory Agents, Non-Steroidal; Diclofenac; Dinoprost; Dinoprostone; Dyspepsia; Endoscopy, Digestive System; Female; Gastric Mucosa; Gastrins; Hip; Hip Joint; Humans; Knee; Knee Joint; Male; Middle Aged; Osteoarthritis, Hip; Osteoarthritis, Knee; Pain Measurement; Phytotherapy; Plant Extracts; Severity of Illness Index; Zingiber officinale

In the present study we evaluated the contents of endogenous prostaglandins type E2 and F2 alpha in the antral mucosa, and the type E2 in the duodenal mucosa in a group of thirty non-ulcer dyspeptics in comparison with a group of thirty duodenal ulcer patients. A significantly reduced concentration of duodenal and antral PGE2 was found in ulcer patients as compared with dyspeptic subjects. A significantly increased concentration of antral PGE2 was observed in cases with active superficial antral gastritis, either in dyspeptics or in duodenal ulcer patients, as compared with normal antrum cases. A significantly increased level of PGF2 alpha was found in active superficial gastritis of the dyspeptic group.

Topics: Adult; Dinoprost; Dinoprostone; Duodenal Ulcer; Duodenum; Dyspepsia; Female; Gastric Acid; Humans; Intestinal Mucosa; Male; Middle Aged; Pyloric Antrum