gastrins and Ulcer

Topics: Adult; Duodenal Ulcer; Female; Gastrectomy; Gastric Juice; Gastric Mucosa; Gastrins; Humans; Intestine, Small; Jejunum; Male; Middle Aged; Neoplasm Metastasis; Radiography; Radioimmunoassay; Ulcer; Zollinger-Ellison Syndrome

We conducted a randomized, double-blind, multicenter clinical trial to determine whether lansoprazole was superior to continued therapy with histamine H2-receptor antagonist therapy in healing erosive reflux esophagitis.. Investigators from nine medical centers enrolled 159 patients with endoscopically documented esophageal erosions and/or ulcers that had failed to heal with 12 or more wk of at least standard dosages of histamine H2-receptor antagonist therapy. Patients received ranitidine 150 mg b.i.d. for 8 wk or lansoprazole 30 mg for 4 wk followed by either lansoprazole 30 mg or lansoprazole 60 mg for another 4 wk of treatment. Patients underwent endoscopy at screening and at weeks 2, 4, and 8.. At 2, 4, and 8 wk of therapy, healing rates were significantly higher in the lansoprazole group compared with the ranitidine group (p < 0.001). By 8 wk, 84% of the lansoprazole group were healed as opposed to only 32% of the ranitidine group. Lansoprazole was superior to ranitidine in providing relief of upper abdominal burning and daytime heartburn (p < 0.001) and reducing the need for antacids (p < 0.001). Lansoprazole patients had less interference with sleep and less day time drowsiness than ranitidine patients (p = 0.05). The percentages of patients with adverse events were similar in both groups. Fasting serum gastrin levels at weeks 4 and 8 were significantly higher in the lansoprazole group compared with the ranitidine group.. Eight weeks of lansoprazole therapy is safe, superior to continued ranitidine therapy, and effective in healing more than 80% of patients with erosive reflux esophagitis previously resistant to histamine H2-receptor antagonist therapy.

Topics: 2-Pyridinylmethylsulfinylbenzimidazoles; Adult; Aged; Antacids; Anti-Ulcer Agents; Double-Blind Method; Drug Resistance; Esophagitis, Peptic; Esophagoscopy; Fasting; Female; Follow-Up Studies; Gastrins; Heartburn; Histamine H2 Antagonists; Humans; Lansoprazole; Male; Middle Aged; Omeprazole; Ranitidine; Safety; Sleep; Sleep Stages; Ulcer; Wound Healing

Reflux esophagitis and gastric tube ulcer sometimes cause severe clinical problems in patients undergoing esophagectomy with gastric tube reconstruction. We previously reported that acidity in the gastric tube was decreased for 1 year after esophagectomy, and that lower acidity levels were associated with Helicobacter pylori (H. pylori) infection. However, the long-term changes in gastric acidity remain unknown. We aimed to investigate the long-term changes in gastric acidity after surgery. Eighty-nine patients who underwent esophagectomy with gastric tube reconstruction for esophageal cancer were analyzed. They underwent 24-hour pH monitoring, serum gastrin measurement, and H. pylori infection examination before surgery, at 1 month, 1 year, and 2 years after surgery. The gastric acidity at 1 month and 1 year after surgery was significantly lower than that before surgery (p=0.003, p=0.003). However, there was no difference in gastric acidity before and 2 years after surgery. The gas tric acidity in H. pylori-infected patients was significantly lower in comparison to non-infected patients at each time point (p=0.0003, p<0.0001, p<0.0001, p<0.0001, respectively). In H. pylori-infected patients, gastric acid ity was decreased for 1 year after surgery, and recovered within 2 years after surgery. However, no significant differences were observed in the acidity levels of non-infected patients during the 2-year follow-up period. The serum gastrin level increased after esophagectomy. The acidity levels in the gastric tube recovered within 2 years after surgery. Periodic endoscopy examination is recommended for early detection of acid-related disease, such as reflux esophagitis or gastric tube ulcer, after esophagectomy with gastric tube reconstruction.

Topics: Esophageal Neoplasms; Esophagectomy; Esophagitis, Peptic; Gastrins; Helicobacter Infections; Humans; Ulcer

Dogs with liver disorders often display gastrointestinal signs that may be triggered by ulceration. The liver is important for inactivation of some forms of gastrin. Therefore, hypergastrinaemia has been implicated in the pathogenesis of gastrointestinal ulcerations related to liver dysfunction. The aim of this study was to determine serum gastrin concentrations in dogs with liver disease. Fasted blood samples were collected from 15 dogs with newly diagnosed liver disease and 18 healthy dogs. Gastrin concentrations were significantly lower in dogs with congenital portosystemic shunt compared with healthy dogs (P=0.003). No significant difference (P=0.6) in gastrin concentration was revealed between dogs with hepatocellular disease and healthy dogs. Serum gastrin concentrations were not significantly associated with the occurrence of vomiting, anorexia, diarrhoea, or melaena in dogs with liver disorders. These findings did not provide support for the role of hypergastrinaemia in the development of gastrointestinal signs associated with liver disease in dogs. Decreased serum concentrations of gastrin in a dog with liver disease may suggest the presence of portosystemic shunt. Further investigation is warranted to determine the importance of hyopogastrinaemia in congenital postosystemic shunts in dogs and to evaluate potential alterations in serum gastrin concentrations in specific hepatocellular diseases.

Topics: Animals; Biomarkers; Case-Control Studies; Dog Diseases; Dogs; Female; Gastrins; Gastrointestinal Diseases; Liver Diseases; Male; Ulcer

Topics: Adult; Gastric Juice; Gastrins; Humans; Intestinal Fistula; Jejunal Diseases; Male; Recurrence; Ulcer

Six dogs underwent bladder augmentation using an isolated flap of the body of the stomach after a supratrigonal cystectomy. Each dog was followed for six months with periodic determinations of urine pH, blood chemistry, cystometry and cystography. Postoperatively, urine pH decreased markedly after a meal in most dogs. No persistent hypergastrinemia was found. Autopsy showed that histological erosions developed in the bladder remnant in five dogs, and an ulcer in the bladder remnant in one dog. These results indicate that when an isolated, vagally denervated gastric segment is incorporated into the bladder, acid secretion from the segment may ulcerate the bladder.

Topics: Anastomosis, Surgical; Animals; Dogs; Female; Gastrins; Hydrogen-Ion Concentration; Stomach; Ulcer; Urinary Bladder; Urinary Bladder Diseases; Urine

The presence of gastrin producing cells in the regenerating mucosa of the small intestine in 9 out of 19 patients with Crohn's disease, nonspecific ulcer or tuberculosis was histochemically examined, employing the method of peroxydase-antiperoxydase complex. Gastrin producing cells were found in 19 out of a total of 23 specimens with pyloric gland metaplasia, whereas they were found to be present in only 1 out of a total of 15 specimens without pyloric gland metaplasia. They were usually seen in the glands adjacent to the metaplastic pyloric glands. No gastrin producing cells were seen in the control specimens. It is suggested that gastric gland metaplasia of the small intestine is a true metaplastic change, into mucosa which has the functional property of the stomach.

Topics: Adult; Aged; Crohn Disease; Female; Gastrins; Humans; Ileal Diseases; Ileum; Intestinal Mucosa; Male; Metaplasia; Middle Aged; Regeneration; Ulcer

Until recently in this unit gastroenterostomy was the operation of choice for patients with duodenal ulcer whose maximal acid output (MAO) is less than 30 mmol/hr. Ulceration (jejunal) has recurred in only 2.1%. Unlike partial gastrectomy, which has a peak incidence of ulcer recurrence in the first two years, the incidence of ulcer recurrence remains constant throughout the years after gastroenterostomy. In looking for the explanation of this low recurrence rate we have studied the effect of the operation upon serum gastrin responses to standardized test meals 3 weeks and 26 weeks after operation in 9 patients. Nine normal subjects acted as controls. Six months after operation the responses were significantly lowered, a fall in the serum levels of gastrin at 30, 45, 60 and 90 min after means suggesting that gastroenterostomy reduces both the gastric and intestinal phases of acid secretion. The mean integrated gastrin response (IGR) throughout the postprandial 90 min is also significantly lower 6 months after surgery. The overall mean reduction was 31.1%.

Topics: Adult; Duodenal Ulcer; Female; Gastric Juice; Gastrins; Gastroenterostomy; Humans; Jejunum; Male; Middle Aged; Peptic Ulcer; Recurrence; Time Factors; Ulcer; Wound Healing

Topics: Gastrins; Humans; Time Factors; Ulcer

Topics: Adolescent; Adult; Aged; Brain Injuries; Child; Female; Gastrins; Gastrointestinal Diseases; Humans; Hydrocortisone; Hypothalamus, Anterior; Male; Melena; Middle Aged; Stress, Physiological; Ulcer

Topics: Acetamides; Acetates; Animals; Duodenum; Gastric Juice; Gastrins; Guinea Pigs; Histamine; Hydrocortisone; Male; Pyridines; Rats; Stomach; Structure-Activity Relationship; Sulfides; Ulcer

Topics: Animals; Dogs; Gastrins; Liver Cirrhosis; Liver Cirrhosis, Experimental; Liver Diseases; Peptic Ulcer; Physiology; Ulcer

Topics: Anesthetics; Anesthetics, Local; Gastrins; Peptic Ulcer; Ulcer

Topics: Adenoma, Islet Cell; Endocrine Glands; Endocrine System Diseases; Gastrins; Gastrointestinal Hormones; Humans; Pancreatic Neoplasms; Peptic Ulcer; Ulcer