intrinsic-factor and Zollinger-Ellison-Syndrome

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

Surgical procedures that lower portal pressure, such as portacaval shunts, prevent variceal hemorrhage. Portal hypertension is the result of increased flow and increased resistance in the portal system. Pharmacologic therapy is aimed at altering these factors by the use of vasoconstrictors to reduce flow and vasodilators to decrease resistance. The current status of pharmacologic agents to achieve these effects is reviewed.

Topics: Anemia, Pernicious; Autoimmune Diseases; Cell Membrane Permeability; Gastric Mucosa; Humans; Ileum; Intestinal Absorption; Intestinal Mucosa; Intrinsic Factor; Metabolic Diseases; Transcobalamins; Vitamin B 12; 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

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: Absorption; Aged; Anemia, Pernicious; Animals; Biological Transport; Chemical Phenomena; Chemistry; Child; Diphyllobothriasis; Food Analysis; Humans; Intestinal Absorption; Intrinsic Factor; Malabsorption Syndromes; Nutritional Requirements; Stomach; Transcobalamins; Vitamin B 12; Vitamin B 12 Deficiency; Zollinger-Ellison Syndrome

Topics: Bile; Gallbladder; Gastric Acidity Determination; Gastric Mucosa; Gastrins; Gastrointestinal Motility; Histamine Release; Humans; Intestinal Mucosa; Intrinsic Factor; Muscle, Smooth; Pancreas; Pepsin A; Peptic Ulcer; Pylorus; 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: 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: Electrolytes; Enzymes; Gastric Acidity Determination; Gastric Juice; Gastric Mucosa; Gastrins; Gastrointestinal Hormones; Histamine; Humans; Intrinsic Factor; Pentagastrin; Pepsinogens; Peptic Ulcer; Secretory Rate; Stomach Neoplasms; Vagus Nerve; Zollinger-Ellison Syndrome

The effects of human urogastrone (0-25 mug. per kg. per hour intravenously) in four male patients with proven Zollinger-Ellison syndrome (z.e.s.) and in four healthy control subjects have been studied. After urogastrone in z.e.s. patients gastric acid volume and concentration decreased and basal acid output was reduced by 50-82%; the concentrations of intrinsic factor and pepsin in gastric juice increased by 60-300%; and peak plasma-gastrin concentration increased by 127-164% of basal concentration. A significant negative correlation between increase in plasma-gastrin concentration and decrease in acid output was observed (r=-0-72, P less than 0-01). Ulcer pain was relieved 30-60 minutes after the beginning of urogastrone infusion. These results suggest that urogastrone can inhibit the endogenously stimulated acid hypersecretion in z.e.s.

Topics: Adult; Depression, Chemical; Epidermal Growth Factor; Gastric Juice; Gastrins; Gastrointestinal Hormones; Humans; Infusions, Parenteral; Intrinsic Factor; Male; Middle Aged; Pepsin A; Zollinger-Ellison Syndrome

Topics: Acid-Base Equilibrium; Gastrins; Humans; Hydrogen-Ion Concentration; Intestinal Absorption; Intestine, Small; Intrinsic Factor; Male; Middle Aged; Vitamin B 12; Zollinger-Ellison Syndrome

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: Antibodies; Celiac Disease; Chromatography, Thin Layer; Duodenum; Gastrectomy; Gastric Juice; Glucose Tolerance Test; Humans; Hydrogen-Ion Concentration; Intestinal Mucosa; Intrinsic Factor; Jejunum; Lipid Metabolism; Lipids; Microscopy, Electron; Pancreas; Schilling Test; Vitamin B 12; Zollinger-Ellison Syndrome

Topics: Absorption; Anemia; Anemia, Pernicious; Biomedical Research; Cobalt Isotopes; Electrophoresis; Gastrectomy; Gastric Juice; Humans; Intrinsic Factor; Radioisotopes; Radionuclide Imaging; Stomach; Urine; Vitamin B 12; Zollinger-Ellison Syndrome