geranylgeranylacetone and Ulcer

Low-dose enteric-coated aspirin is increasingly being used for prevention of cardiovascular disease. The aim of this study was to evaluate whether geranylgeranylacetone (GGA) could prevent aspirin-induced small bowel injury.. This was a prospective, randomized, double-blind, pilot study of GGA versus placebo in subjects taking low-dose enteric-coated aspirin. Young healthy volunteers were enrolled and each received 100 mg of enteric-coated aspirin per day plus either GGA (150 mg/day) or matching placebo for 7 days. Video capsule endoscopy of the small bowel and the Gastrointestinal Symptom Rating Scale (GSRS) questionnaire were performed before and after the administration of aspirin.. Twenty volunteers were evaluated. There was no significant difference in the number of lesions in any category between those receiving or not receiving GGA. Large erosions or ulcers were observed in 12 (60%; 95% confidence interval 36%- 80%) aspirin users. Mucosal breaks were most frequently found in the latter half of the proximal small bowel.. Short-term administration of low-dose enteric-coated aspirin was associated with visible small bowel damage in the majority of users. We could not prove that aspirin-induced small bowel mucosal injury was prevented by GGA.

Topics: Adult; Anti-Ulcer Agents; Aspirin; Diterpenes; Double-Blind Method; Female; Humans; Intestine, Small; Male; Pilot Projects; Platelet Aggregation Inhibitors; Tablets, Enteric-Coated; Treatment Outcome; Ulcer

Upper gastrointestinal bleeding is a lethal complication after open heart surgery. We designed a prospective randomized trial to test the efficacy of different antisecretory agents to prevent upper gastrointestinal disease after operation.. A total of 210 patients were divided into 3 groups: group I had 70 patients who had mucosal protection (teprenone 150 mg/day), group II had 70 patients who had histamine2-receptor antagonist (ranitidine 300 mg/day), and group III included 70 patients who had a proton pump inhibitor (rabeprazole 10 mg/day). Gastric fiberscopy was used in all patients postoperatively during days 5 to 7. We compared the 3 groups in terms of endoscopic findings. Four patients (5.7%) had gastric bleeding complications in each of groups I and II; 2 died of coagulopathy. In group III no patients had gastric bleeding. The incidence of hemorrhagic gastritis was significantly higher in groups I (22.9%) and II (15.7%) than in III (2.9%) (p=0.0003). The incidence of active ulcers was also significantly higher in groups I (28.6%) and II (21.4%) than in III (4.3%) (p=0.0001).. Early medication postoperative by a proton pump inhibitor was shown to be the most effective treatment and indeed might be described as mandatory to prevent upper gastrointestinal diseases after open heart surgery.

Topics: 2-Pyridinylmethylsulfinylbenzimidazoles; Anti-Ulcer Agents; Benzimidazoles; Cardiac Surgical Procedures; Diterpenes; Endoscopy, Gastrointestinal; Gastritis; Gastrointestinal Diseases; Gastrointestinal Hemorrhage; Histamine H2 Antagonists; Humans; Incidence; Omeprazole; Postoperative Complications; Premedication; Proton-Translocating ATPases; Rabeprazole; Ranitidine; Ulcer; Upper Gastrointestinal Tract

Early gastric cancer is a common, malignant, tumor disease. Compared with traditional surgical methods, endoscopic mucosal dissection (ESD) is a minimally invasive surgery; however, in practice, it still carries some surgical risks. Teprenone is a common drug that protects the gastric mucosa and promotes the recovery of gastric mucosal and gastrointestinal function.. The study intended to investigate the clinical efficacy of endoscopic mucosal dissection combined with teprenone for early gastric cancer, including an evaluation of the combined treatment using the eCura scoring system, with a view to providing the results as a reference for the choice of treatment modality for early gastric cancer.. The research team performed a prospective controlled study.. The study took place in the Department of General Surgery, Huidong, at Zigong Fourth People's Hospital in Zigong, China.. Participants were patients with early gastric cancer, 58 who were admitted to the hospital between January 2019 and June 2020 and 58 who were admitted between July 2020 and December 2021.. The research team assigned: (1) the 58 patients in the earlier group to the control group, and they received treatment using endoscopic mucosal dissection; and (2) the 58 patients in the latter group to be the intervention group, and they received treatment using endoscopic mucosal dissection combined with teprenone.. The research team examined participants' postoperative: (1) abdominal pain scores; (2) size of ulcer wound area, (3) complications-delayed bleeding, ulcer perforation, fever, or abdominal pain; (4) risk as measured by the eCura scoring system-low, medium, or high risk; and (5) survival rates of those assessed at different risks under the eCura scoring systems.. Postoperatively, the intervention group's abdominal pain scores on days 3 and 5 and the size of the groups' ulcer areas at days 7 and 14 were significantly lower than those of the control group (all P < .001). The intervention group's total incidence of postoperative complications, at 3.45%, was significantly lower than that in the control group, at 20.69% (P = .004). The number of participants low risk was 39 (67.25%), as assessed by eCura scoring system, which was significantly higher than that of the control group, at 22 participants (37.93%). The intervention groups' overall survival rate, at 98.28%, was significantly higher than that of the control group, at 69.49% (P < .001).. Endoscopic mucosal dissection combined with teprenone as a treatment for early gastric cancer can achieve a significantly better therapeutic effect than can endoscopic mucosal dissection only. It can reduce the risk of postoperative complications and improve the assessment of risk found with the eCura scoring system. It can have an important role in improving the postoperative survival rate of patients with early gastric cancer and is worthy of clinical application.

Topics: Endoscopic Mucosal Resection; Humans; Prospective Studies; Retrospective Studies; Stomach Neoplasms; Treatment Outcome; Ulcer

Nonsteroidal anti-inflammatory drugs induce small intestinal ulcers but the preventive measures against it remain unknown. So we evaluated the effect of geranylgeranylacetone (GGA), a mucosal protectant, on both the mucus content and loxoprofen sodium-induced lesions in the rat small intestine. Normal male Wistar rats were given GGA (200 or 400mg/kg p.o.) and euthanized 3h later for measurement of mucin content and immunoreactivity. Other Wistar rats were given loxoprofen sodium (30mg/kg s.c.) and euthanized 24h later. GGA (30-400mg/kg p.o.) was administered twice: 30min before and 6h after loxoprofen sodium. The total mucin content of the small intestinal mucosa increased, especially the ratio of sialomucin, which increased approximately 20% more than the control level after a single dose of GGA. Loxoprofen sodium provoked linear ulcers along the mesenteric margin of the distal jejunum, accompanied by an increase in enterobacterial translocation. Treatment of the animals with GGA dose-dependently prevented the development of intestinal lesions, and bacterial translocation following loxoprofen sodium was also significantly decreased. GGA protects the small intestine against loxoprofen sodium-induced lesions, probably by inhibiting enterobacterial invasion of the mucosa as a result of the increase in the mucosal barrier.

Topics: Animals; Anti-Inflammatory Agents, Non-Steroidal; Anti-Ulcer Agents; Diterpenes; Dose-Response Relationship, Drug; Enterobacteriaceae; Intestine, Small; Male; Phenylpropionates; Rats; Rats, Wistar; Sialomucins; Ulcer