intrinsic-factor and Duodenal-Ulcer

Topics: Absorption; Cimetidine; Duodenal Ulcer; Gastrectomy; Gastric Acid; Gastritis, Atrophic; Humans; Intrinsic Factor; Omeprazole; Ranitidine; Reference Values; Vitamin B 12

Topics: Animals; Digestive System; Digestive System Physiological Phenomena; Duodenal Ulcer; Gastric Acid; Gastrins; Gastritis; Histamine; Histamine H2 Antagonists; Humans; Intrinsic Factor; Liver Circulation; Pepsinogens; Receptors, Histamine; Receptors, Histamine H1; Receptors, Histamine H2; Regional Blood Flow; Stomach; Stomach Ulcer; Zollinger-Ellison Syndrome

Topics: Burimamide; Chemical Phenomena; Chemistry; Cimetidine; Duodenal Ulcer; Esophagitis, Peptic; Gastric Acid; Gastrins; Gastrointestinal Hemorrhage; Histamine; Histamine H1 Antagonists; Histamine H2 Antagonists; Humans; Hypersensitivity; Intrinsic Factor; Kinetics; Malabsorption Syndromes; Metiamide; Pancreas; Pepsin A; Ranitidine; Receptors, Histamine H2; Stomach Ulcer; Stress, Psychological; Zollinger-Ellison Syndrome

The value of cimetidine in treatment of duodenal ulcer and the Zollinger-Ellison syndrome appears to be well established. The drug has been enthusiastically embraced and widely used by practicing physicians. As with virtually all drugs used in the practice of medicine, cimetidine is not without its adverse effects. In some instances these effects may result from actions of cimetidine on H2-receptors on many widely distributed and diverse cells other than parietal cells, to which its potent acid-inhibiting properties are directed. Other adverse effects of cimetidine may be idiosyncratic, and, therefore, not predictable on a pharmacologic basis. In some instances the mechanisms responsible for cimetidine's adverse effects hav e yet to be defined. An assortment of abnormalities reported in patients receiving cimetidine have been suggested, but not proven, to represent adverse effects of the drug. Considering its extremely wide use, serious toxicity with cimetidine is rare. However, no potent drug, including cimetidine, used in the practice of medicine is without its adverse effects. Recognizing the present and projected extensive and probably long-term use of cimetidine, physicians and surgeons treating patients with cimetidine must maintain continued surveillance in order to detect and clarify potential undesired consequences of cimetidine administration.

Topics: Agranulocytosis; Animals; Bone Marrow; Central Nervous System; Chemical and Drug Induced Liver Injury; Cimetidine; Creatinine; Duodenal Ulcer; Endocrine Glands; Gastric Juice; Gastrins; Guanidines; Humans; Immunity, Cellular; Intrinsic Factor; Liver; Pancreatitis; Receptors, Histamine H2; Risk; Stomach Neoplasms; Transaminases

Development of histamine H2-receptor antagonists has enhanced the understanding of histamine physiology and pharmacology. The effect of H2-receptor antagonists on gastrointestinal physiology has been studied extensively. These compounds inhibit gastric acid secretion in response to all known secretagogues and, in contrast to anticholinergic drugs, markedly inhibit food-stimulated acid secretion in duodenal ulcer patients. The relative roles of H2-receptor antagonists, anticholinergic drugs and antacids in the treatment of duodenal ulcer remain to be defined. Cimetidine currently is under investigation for the treatment of duodenal ulcer, gastric ulcer, reflux esophagitis, gastrointestinal bleeding and hypersecretory states. Although the long-term safety of cimetidine has not been established, in short-term clinical trials there have been no significant subjective or objective side-effects. Assuming that toxic effects do not develop, H2-receptor antagonists should improve the treatment of acid-peptic disease.

Topics: Cimetidine; Cyclic AMP; Duodenal Ulcer; Esophagitis, Peptic; Gastric Juice; Gastrins; Gastritis; Gastrointestinal Hemorrhage; Histamine; Histamine H2 Antagonists; Humans; Intrinsic Factor; Metiamide; Pepsin A; Stomach Ulcer

Cimetidine is a specific competitive histamine H2-receptor antagonist which effectively inhibits gastric acid secretion and is advocated for the treatment of chronic peptic ulceration, haemorrhage from erosive gastritis, and the control of gastric hypersecretion and peptic ulceration in the Zollinger-Ellison syndrome. Placebo-controlled trials in outpatients have demonstrated its efficacy in promoting the healing of endoscopically diagnosed duodenal ulceration, during a period of 4 to 6 weeks, but its role in the treatment of gastric ulcer is less clear. Preliminary evidence suggests that maintenance therapy with cimetidine reduces the rate of recurrence of duodenal ulcer, but further studies are required to clarify its role in this situation and in the treatment of oesophagitis and acute gastrointestinal haemorrhage. Cimetidine controls the peptic ulceration of Zollinger-Ellison syndrome in most patients when given continuously for up to 2 years. Side-effects have generally been trivial and have very seldom necessitated withdrawal of therapy except in the rare occurrence of gynaecomastia. The haematological abnormalities particularly agranulocytosis, which lead to the withdrawal from clinical use of metiamide, have not been reported with cimetidine, except for 1 case of transient neutropenia. The safety of long-term cimetidine administration has yet to be determined.

Topics: Acute Disease; Animals; Cimetidine; Duodenal Ulcer; Gastric Juice; Gastrins; Gastrointestinal Hemorrhage; Guanidines; Humans; Intrinsic Factor; Recurrence; Stomach Ulcer; Zollinger-Ellison Syndrome

Topics: Acetylcholine; Achlorhydria; Adenoma; Anemia, Pernicious; Atrophy; Duodenal Ulcer; Endocrine System Diseases; Gastrectomy; Gastric Juice; Gastric Mucins; Gastric Mucosa; Gastrins; Gastritis; Humans; Hyperplasia; Intrinsic Factor; Stomach Ulcer; Vagus Nerve; Zollinger-Ellison Syndrome

Topics: Antibodies; Autoradiography; Chronic Disease; Depression, Chemical; Duodenal Ulcer; Gastric Juice; Gastric Mucosa; Gastritis; Histamine; Humans; Insulin; Intrinsic Factor; Methods; Protein Binding; Radioisotopes; Stimulation, Chemical; Stomach Neoplasms; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Blood Group Antigens; Duodenal Ulcer; Electrolytes; Gastric Acidity Determination; Gastritis; Humans; Hydrochloric Acid; Intrinsic Factor; L-Lactate Dehydrogenase; Pepsin A; Stomach Neoplasms; Stomach Ulcer; Zollinger-Ellison Syndrome

Topics: Cimetidine; Depression, Chemical; Duodenal Ulcer; Female; Gastric Juice; Guanidines; Humans; Intrinsic Factor; Male; Secretory Rate

Topics: Adolescent; Adult; Aged; Atropa belladonna; Disability Evaluation; Duodenal Ulcer; Female; Gastric Acidity Determination; Gastric Juice; Histamine; Humans; Intrinsic Factor; Male; Middle Aged; Parasympatholytics; Phytotherapy; Placebos; Plants, Medicinal; Plants, Toxic; Radiography; Vitamin B 12

The effects of ranitidine, a new potent histamine H2-receptor antagonist, on gastric intrinsic factor (IF) secretion and protein-bound cobalamin absorption were evaluated in 6 patients with duodenal ulcer, before, during and after discontinuation of ranitidine therapy. Oral ranitidine (150 mg twice a day) resulted in a non significant decrease of IF concentration and IF output but was responsible for malabsorption of protein-bound cobalamin. This malabsorption was reversible upon discontinuation of ranitidine. These results indicate that occurrence of cobalamin deficiency cannot be excluded during long-term ranitidine treatment and emphasize the need for careful follow-up in these patients.

Topics: Adult; Anti-Ulcer Agents; Duodenal Ulcer; Furans; Histamine H2 Antagonists; Humans; Intestinal Absorption; Intrinsic Factor; Middle Aged; Ranitidine; Vitamin B 12

Topics: Adult; Duodenal Ulcer; Furans; Histamine H2 Antagonists; Humans; Intestinal Mucosa; Intrinsic Factor; Middle Aged; Pentagastrin; Ranitidine; Secretory Rate

Topics: Duodenal Ulcer; Furans; Histamine H2 Antagonists; Humans; Intrinsic Factor; Ranitidine

A one-hour infusion of 0.25 micrograms/kg urogastrone administered to seven patients with duodenal ulceration resulted in significant reduction of basal acid secretion (p less than 0.05) but was without significant effect on basal pepsin and intrinsic factor secretion or on serum gastrin concentration. In another group of five patients with duodenal ulceration a one-hour infusion of urogastrone was given on five successive days. On day 1 and 5 urogastrone was administered after establishing a plateau response to intravenous pentagastrin 1.2 micrograms/kg/h. A mean reduction of 65% in acid output during the urogastrtone infusion was seen on day 1 and this was maintained during the next hour. On day 5 the pentagastrin-stimulated acid output was less than on day 1 and a further significant decrease was noted after urogastrone. Pepsin and intrinsic factor output were also significantly inhibited. There was no change in fasting serum gastrin or urogastrone concentration.

Topics: Adult; Duodenal Ulcer; Epidermal Growth Factor; Gastric Acid; Gastric Juice; Gastrins; Humans; Intrinsic Factor; Male; Middle Aged; Pentagastrin; Pepsin A; Secretory Rate; Time Factors

The effect on intrinsic factor (IF) secretion of eight weeks' continuous treatment with a clinically relevant oral dose of ranitidine hydrochloride, a new histamine H2-receptor antagonist, has been studied in 11 patients with duodenal ulcer. There was no significant difference between the mean IF output during treatment of after drug withdrawal as compared with the control value, despite highly significant (p less than 0.001) reduction in acid output during treatment. In the short term this potent drug is unlikely to cause pernicious anemia from interference with IF secretion, although further study is necessary to exclude this possibility after long-term use.

Topics: Adolescent; Adult; Duodenal Ulcer; Female; Furans; Gastric Acid; Histamine H2 Antagonists; Humans; Intrinsic Factor; Male; Middle Aged; Ranitidine

The suppressive effects of cimetidine on acid, pepsin, and intrinsic factor secretion have been well documented; however, the effect of cimetidine on cobalamin absorption has not been assessed. The absorption of both unbound [57Co]cyanocobalamin and protein-bound [57Co]cyanocobalamin was evaluated in 12 patients with duodenal ulcer disease during and after discontinuation of cimetidine therapy. Cimetidine administration did not lead to malabsorption of unbound cobalamin but caused malabsorption of protein-bound cobalamin (0.22 +/- 0.08%, [mean +/- 1 SEM] versus 2.3 +/- 0.10% in control subjects, P less than 0.01). This malabsorption was reversible upon discontinuation of cimetidine. Patients on cimetidine therapy malabsorb protein-bound cobalamin and, during long-term treatment, are at risk for developing cobalamin deficiency. This malabsorption was reversible upon discontinuation of cimetidine. Patients on cimetidine therapy malabsorb protein-bound cobalamin and, during long-term treatment, are at risk for developing cobalamin deficiency. This malabsorption of protein-bound cobalamin is not detectable by the usual tests of cobalamin absorption which employ unbound cobalamin.

Topics: Cimetidine; Duodenal Ulcer; Gastric Juice; Guanidines; Humans; Intestinal Absorption; Intrinsic Factor; Male; Pepsin A; Protein Binding; Vitamin B 12

The effect os somatostatin (0.6 mg/hour) on insulin-stimulated gastrin release and gastric secretion of acid, pepsin, and IF has been examined in 6 unoperated patients with duodenal ulcer. Gastrin release and gastric secretion of acid, pepsin, and IF in response to insulin alone (0.15 IU/kg bw. iv.) were significantly reduced by simultaneous administration of somatostatin. This finding indicates an inhibitory effect of somatostatin on insulin-induced gastrin release and gastrin secretion in addition to the already known effects of somatostatin.

Topics: Blood Glucose; Drug Interactions; Duodenal Ulcer; Gastric Juice; Gastrins; Humans; Insulin; Insulin Antagonists; Intrinsic Factor; Pentagastrin; Pepsin A; Secretory Rate; Somatostatin

Of 160 patients with pernicious anaemia, none had current duodenal ulceration, whereas in a random population of similar age and sex distribution some 5% would be expected to have a duodenal ulcer. Parietal-cell antibody was detected in serum from 8 of 169 men (4-7%) and from 2 to 31 women (6-4%) with duodenal ulceration. None of the 200 duodenal ulcer patients had antibody to intrinsic factor. The prevalence of these antibodies in duodenal ulcer patients was not significantly different from that in control subjects of similar age and sex distribution. The decreased prevalance of duodenal ulcer in pernicious anaemia patients implies that pernicious anaemia must be less prevalent in duodenal ulcer patients than in a random population; but it appears that this cannot be attributed to an absence of gastric autoimmunity in patients with duodenal ulcer. To resolve this disrepancy, we suggest that pernicious anaemia is determined not only by autoimmune reactions, but also by independent genetic and environmental factors which influence the state of the gastric mucosa.

Topics: Adult; Anemia, Pernicious; Autoantibodies; Duodenal Ulcer; Female; Gastric Mucosa; Humans; Intrinsic Factor; Male; Middle Aged

The gastric secretion of IF, acid, and pepsin during basal conditions and stimulation by pentagastrin decreased significantly in 8 unoperated duodenal ulcer patients following administration of atropine. The basal concentrations of acid and pepsin decreased, whereas that of IF remained unchanged. An increase of plasma gastrin concentration from the basal value was observed after injection of atropine alone. The secretions of IF and acid decreased significantly from the pre-operative values after proximal gastric vagotomy in 7 duodenal ulcer patients. The basal IF output decreased by 19.8 per cent and the stimulated output by 41.4 per cent. The basal and stimulated secretions of acid decreased by 50.0 and 44.1 per cent, respectively. It is suggested that the smaller reduction of IF than of acid may be of importance for the vitamin B12 absorption after vagotomy. The decreased secretion of IF was secondary to the reduction of volume both after'medical' and surgical vagotomy.

Topics: Atropine; Blood Glucose; Depression, Chemical; Duodenal Ulcer; Female; Gastric Acidity Determination; Gastric Juice; Gastrins; Humans; Hydrogen-Ion Concentration; Intrinsic Factor; Male; Pentagastrin; Pepsin A; Secretory Rate; Stimulation, Chemical; Vagotomy; Vitamin B 12

Topics: Anemia, Pernicious; Biopsy; Body Weight; Dumping Syndrome; Duodenal Ulcer; Dyspepsia; Female; Follow-Up Studies; Gastrectomy; Gastric Mucosa; Hemoglobins; Humans; Intestinal Absorption; Intrinsic Factor; Iron; Male; Postgastrectomy Syndromes; Schilling Test; Stomach Ulcer; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Atropine; Blood Glucose; Depression, Chemical; Duodenal Ulcer; Gastric Juice; Gastrins; Humans; Insulin; Intrinsic Factor; Pentagastrin; Pepsin A; Secretory Rate; Stimulation, Chemical; Time Factors

Topics: Administration, Oral; Anemia, Pernicious; Animals; Cobalt Radioisotopes; Duodenal Ulcer; Gastric Juice; Humans; Intestinal Absorption; Intestinal Mucosa; Intrinsic Factor; Intubation, Gastrointestinal; Male; Obesity; Pentagastrin; Protein Binding; Rats; Spinal Diseases; Swine; Vitamin B 12

Topics: Achlorhydria; Atrophy; Autoantibodies; Biopsy; Duodenal Ulcer; Duodenum; Follow-Up Studies; Gastrectomy; Gastric Mucosa; Gastritis; Humans; Intrinsic Factor; Iron; Postoperative Complications; Stomach

Topics: Adult; Age Factors; Aged; Alcohol Drinking; Duodenal Ulcer; Erythrocytes; Follow-Up Studies; Gastrectomy; Gastric Juice; Humans; Intrinsic Factor; Leiomyoma; Methods; Middle Aged; Pepsin A; Postoperative Complications; Schilling Test; Stomach Neoplasms; Stomach Ulcer; Time Factors; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Duodenal Ulcer; False Negative Reactions; False Positive Reactions; Gastric Acidity Determination; Gastric Juice; Gastric Mucosa; Gastritis; Histamine; Humans; Intrinsic Factor; Peptides; Stomach; Stomach Neoplasms; Stomach Ulcer; Time Factors; Vagotomy; Vagus Nerve; Zollinger-Ellison Syndrome

Topics: Adult; Antibodies; Biopsy; Diabetes Mellitus; Duodenal Ulcer; Fluorescent Antibody Technique; Gastritis; Gastrointestinal Diseases; Humans; Intrinsic Factor; Middle Aged; Stomach; Stomach Neoplasms; Stomach Ulcer

Topics: Achlorhydria; Anemia, Pernicious; Duodenal Ulcer; Female; Gastric Juice; Gastric Mucosa; Histamine; Humans; Intrinsic Factor; Male; Radioimmunoassay; Stimulation, Chemical; Stomach; Stomach Diseases; Stomach Neoplasms; Stomach Ulcer

Topics: Anemia, Hypochromic; Cobalt Isotopes; Duodenal Ulcer; Female; Gastrectomy; Humans; Intrinsic Factor; Iron; Male; Peptic Ulcer; Postgastrectomy Syndromes; Schilling Test; Stomach Neoplasms; Vitamin B 12

Topics: Adult; Age Factors; Duodenal Ulcer; Female; Gastric Acidity Determination; Gastric Juice; Gastrins; Histamine; Humans; Injections, Subcutaneous; Intrinsic Factor; Male; Methods; Middle Aged; Radioimmunoassay; Stomach Ulcer; Time Factors; Vitamin B 12

Topics: Atropa belladonna; Duodenal Ulcer; Gastric Acidity Determination; Gastric Juice; Histamine; Humans; Intrinsic Factor; Male; Plants, Medicinal; Plants, Toxic

Topics: Duodenal Ulcer; Gastric Juice; Histamine; Humans; Intrinsic Factor; Male

Topics: Duodenal Ulcer; Histamine; Humans; Intrinsic Factor; Peptic Ulcer; Secretory Rate; Stomach Neoplasms

Topics: Adult; Aged; Atropa belladonna; Chronic Disease; Delayed-Action Preparations; Duodenal Ulcer; Gastric Acidity Determination; Gastric Juice; Histamine; Humans; Intrinsic Factor; Male; Middle Aged; Pepsin A; Phytotherapy; Plants, Medicinal; Plants, Toxic; Secretory Rate; Vagotomy

Topics: Adult; Duodenal Ulcer; Gastric Acidity Determination; Gastric Juice; Histamine; Humans; Insulin; Intrinsic Factor; Male; Middle Aged; Pepsin A; Vagotomy

Topics: Duodenal Ulcer; Gastric Mucosa; Humans; Intrinsic Factor; Protein Hydrolysates

Topics: Adult; Aged; Anemia, Pernicious; Duodenal Ulcer; Female; Gastric Acidity Determination; Gastric Juice; Gastritis; Histamine; Humans; Intrinsic Factor; Male; Middle Aged; Secretory Rate

Topics: Anemia, Pernicious; Antibodies; Autoantibodies; Duodenal Ulcer; Fluorescent Antibody Technique; Gastric Mucosa; Humans; Hypothyroidism; Immune Tolerance; In Vitro Techniques; Intrinsic Factor; Pneumomediastinum, Diagnostic; Tomography

Topics: Anemia; Anemia, Hypochromic; Anemia, Macrocytic; Carbachol; Celiac Disease; Cobalt Isotopes; Colonic Neoplasms; Duodenal Ulcer; Folic Acid; Folic Acid Deficiency; Gastric Acidity Determination; Gastric Juice; Histamine; Humans; Insulin; Intrinsic Factor; Male; Pharmacology; Physiology; Sprue, Tropical; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Digestion; Duodenal Ulcer; Electrophoresis; Gastric Juice; Heating; Humans; Intrinsic Factor; Vitamin B 12

Topics: Atrophy; Duodenal Ulcer; Gastritis; Gastritis, Atrophic; Humans; Intrinsic Factor; Polyps; Stomach Diseases; Stomach Neoplasms; Stomach Ulcer; Vitamin B 12