oxytetracycline--anhydrous and Duodenal-Ulcer

The aim of the study was to compare relapse rates and quality of life before and after eradication of Helicobacter pylori in a group of patients with documented recurrent duodenal ulcer disease.. Seventy-four patients with three endoscopically verified duodenal ulcers during the past 2 years received triple treatment consisting of bismuth subnitrate, oxytetracycline, and metronidazole for 14 days. Quality of life was measured with the Psychosocial Adjustment to Illness Scale (PAIS-SR) and H. pylori status with the 14C-urea breath test.. After triple treatment H. pylori was eradicated in 96%, and the ulcer was healed in all. Ulcer relapse was reduced from 100% before to 1.4% during a mean observation time of 111 weeks. The H. pylori reinfection rate was 2.4% during the 1st year. The patients were more satisfied with the health care system and had better sexual relationship and less psychologic distress 1 year after eradication of H. pylori than before.. For patients with recurrent duodenal ulcer, eradication of H. pylori with triple treatment leads to a significantly reduced ulcer relapse rate and improved quality of life.

Topics: Adolescent; Adult; Antacids; Bismuth; Cognitive Behavioral Therapy; Combined Modality Therapy; Drug Therapy, Combination; Duodenal Ulcer; Female; Follow-Up Studies; Helicobacter Infections; Helicobacter pylori; Humans; Male; Metronidazole; Middle Aged; Oxytetracycline; Prospective Studies; Quality of Life; Recurrence; Severity of Illness Index; Time Factors

Duodenal and gastric content of mucosal enzymes in duodenal ulcer (DU) patients differs from that of controls. The purpose of this study has been to examine the effect of omeprazole and eradication of Helicobacter pylori on mucosal enzymes in DU patients.. The enzyme activities of seven gastric and duodenal mucosal marker enzymes from the brush border, lysosomes, and mitochondria have been studied. In study I the measurements were made in 29 patients with an active DU before and after 14 days of omeprazole treatment. In study II 22 duodenal ulcer patients were given bismuth subnitrate, oxytetracycline, and metronidazole (triple therapy) for 2 weeks to eradicate H. pylori. Biopsy specimens were taken from the duodenum and the stomach for enzyme measurements and histologic assessment. In study II additional specimens were obtained from the prepyloric region for urease tests and culture of H. pylori.. The ulcer healing rates were more than 90% after both omeprazole and triple therapy. H. pylori was eradicated in 86% after triple therapy. The activities of the brush-border enzymes lactase, neutral-alpha-glucosidase, alkaline phosphatase, leucyl-beta-naphthylamidase, and gamma-glutamyltransferase (gamma-GT) increased significantly in the duodenal bulb and the descending duodenum during treatment with omeprazole. No changes in duodenal enzyme activity were detected after triple therapy, whereas a significant fall in gamma-GT and acid phosphatase activities was seen in the stomach. The mucosal DNA in the gastric antrum decreased both after treatment with omeprazole and after triple therapy.. A similar decrease in mucosal DNA of the gastric antrum was demonstrated after both omeprazole and triple therapy with bismuth subnitrate, oxytetracycline, and metronidazole. Omeprazole also affects the content of duodenal mucosal enzymes, whereas triple therapy particularly affects the gastric mucosal enzyme activity.

Topics: Antacids; Biopsy; Bismuth; DNA; Drug Therapy, Combination; Duodenal Ulcer; Duodenum; Female; Gastric Mucosa; Gastrins; Helicobacter Infections; Helicobacter pylori; Humans; Intestinal Mucosa; Male; Metronidazole; Middle Aged; Omeprazole; Oxytetracycline; Stomach

Topics: Anti-Ulcer Agents; Drug Resistance, Microbial; Drug Therapy, Combination; Duodenal Ulcer; Gastroscopy; Helicobacter Infections; Helicobacter pylori; Humans; Metronidazole; Organometallic Compounds; Oxytetracycline; Ranitidine

Ascorbic acid, the reduced form of vitamin C, may protect against gastric cancer and is secreted by the normal stomach. Secretion is impaired in Helicobacter pylori (H pylori) associated chronic gastritis. This study examined if eradication of H pylori improves gastric juice ascorbate values. Fasting gastric juice and plasma samples were collected at endoscopy from patients participating in trials of H pylori eradication for duodenal ulcer disease and intestinal metaplasia before and up to 15 months after attempted eradication. Ascorbic acid and total vitamin C concentrations were determined by high performance liquid chromatography. In 12 patients in whom H pylori was successfully eradicated gastric juice ascorbate and total vitamin C concentrations and the ratio of juice to plasma vitamin C rose after treatment. Analysis after treatment suggested that the rise was greatest in patients with high final plasma vitamin C concentrations, even though these did not change with treatment. By contrast, in 22 patients in whom H pylori eradication was unsuccessful there were no significant changes in juice or plasma concentrations after treatment. It is concluded that successful eradication of H pylori improves secretion of vitamin C into gastric juice. It is speculated that this increases protection against gastric cancer.

Topics: Aged; Ampicillin; Anti-Ulcer Agents; Ascorbic Acid; Drug Therapy, Combination; Duodenal Ulcer; Fasting; Follow-Up Studies; Gastric Juice; Helicobacter Infections; Helicobacter pylori; Humans; Intestines; Male; Metaplasia; Metronidazole; Organometallic Compounds; Oxytetracycline; Treatment Outcome

Despite the close association between gastric Helicobacter pylori infection and duodenal ulcer, little is known about how this organism may promote mucosal damage. A possibility might be that it produces, or induces the host to release, phospholipases that metabolize the protective layer of phospholipids.. Aimed at determination of phospholipase A2 activity and the concentration of choline-containing phospholipids in gastric juice, aspirates were collected during gastroscopy in 38 consecutive referrals with either active (n = 19) or H. pylori-eradicated healed duodenal ulcer (n = 19).. Gastric juice phospholipase A2 activity was 3.1 times higher in active than in healed duodenal ulcers (P = 0.03). Concurrently, the concentration of choline-containing phospholipids in the group with active ulcers was less than half compared with the healed group (P = 0.02).. The results indicate that phospholipase A2 activity and the concentration of choline-containing phospholipids in gastric juice are related to H. pylori status and duodenal ulcer disease.

Topics: Adult; Aged; Bile Acids and Salts; Bismuth; Choline; Drug Therapy, Combination; Duodenal Ulcer; Female; Gastric Juice; Helicobacter Infections; Helicobacter pylori; Humans; Hydrogen-Ion Concentration; Male; Metronidazole; Middle Aged; Oxytetracycline; Phospholipases A; Phospholipases A2; Phospholipids

60 patients with recurrent duodenal ulcers were treated with bismuth subnitrate, oxytetracycline and metronidazole. Helicobacter pylori status was assessed before and after treatment by means of the 14C-urea breath test. All patients were helicobacter positive before treatment. Four weeks after cessation of therapy H pylori had been eradicated in 57 out of 60 patients (95%). The ulcer healing rate was 100% after six weeks. 43% of the patients complained of moderate to severe side effects, mainly nausea and diarrhoea, but no patients discontinued the treatment prematurely. The study indicates that nearly all patients with recurrent duodenal ulcer are infected with H pylori, and that the present triple treatment regimen is very effective both in eradicating H pylori and in healing the ulcer.

Topics: Adult; Bismuth; Drug Therapy, Combination; Duodenal Ulcer; Female; Helicobacter pylori; Humans; Male; Metronidazole; Middle Aged; Oxytetracycline; Recurrence; Stomach Ulcer

Topics: Acetylcysteine; Adult; Bronchitis; Cystic Fibrosis; Duodenal Ulcer; Humans; Male; Middle Aged; Oxytetracycline; Pancreatic Juice; Sweat