simethicone and Esophagitis

Four antacid preparations have been studied in a stratified, randomized, double-blind trial to evaluate criteria which determine patients' acceptance of this type of therapy. There was a considerable range of judgements about palatability, but preference was determined not only by factors such as the smell, taste, texture and after-taste of the preparation, but also by the order in which the antacids were tested and by the age and sex of the patient. The preparations also differed considerably in acid-neutralizing capacity and ability to bind bile salts, as well as cost. We conclude that individuals requiring antacid therapy should be allowed to chose from among a range of preparations, in order to maximize compliance.

Topics: Adult; Aged; Alginates; Aluminum Compounds; Aluminum Hydroxide; Aluminum Silicates; Antacids; Bicarbonates; Clinical Trials as Topic; Dimethylpolysiloxanes; Double-Blind Method; Drug Combinations; Esophagitis; Female; Humans; Magnesium; Magnesium Compounds; Magnesium Hydroxide; Magnesium Oxide; Male; Middle Aged; Patient Acceptance of Health Care; Peptic Ulcer; Random Allocation; Silicates; Silicic Acid; Silicon Dioxide; Silicones; Simethicone; Sodium Bicarbonate

Twenty seven children who had been diagnosed as having idiopathic chest pain were investigated to find out if the pain was of gastrointestinal origin. The symptoms had lasted from two weeks to eight months. In 21 of the 27 children (78%) the chest pain had a gastrointestinal cause: 16 had oesophagitis, four had gastritis, and one had diffuse oesophageal spasm. All patients responded to medical treatment of their gastrointestinal symptoms, resulting in disappearance of the chest pain.

Topics: Adolescent; Adult; Chest Pain; Child; Dicyclomine; Endoscopy; Esophageal Spasm, Diffuse; Esophagitis; Female; Gastritis; Humans; Male; Manometry; Pressure; Ranitidine; Simethicone

Artifacts related to barium flow during double-contrast esophagography may obscure mucosal surface details. Double-contrast esophagograms with flow artifacts of 35 patients were evaluated to determine the effect on radiographic interpretation and to assess the method of examination. Initial radiographs obtained during swallowing of barium were compared with those obtained after a slight delay while patients repeatedly dry swallowed. When severe surface flow artifacts were present, the extent of mucosal disease was underestimated in all cases. Mild surface flow artifacts interfered with the demonstration of the reticular pattern of Barrett esophagus, and luminal flow artifacts caused misinterpretation. The demonstration of strictures was unaffected by flow artifacts. This study suggests that the dry swallowing maneuver and some delay improve depiction of esophageal surface details on double-contrast radiographs and obviate interpretive error from barium flow artifacts.

Topics: Barium Sulfate; Bicarbonates; Citrates; Citric Acid; Deglutition; Drug Combinations; Esophagitis; Esophagus; Humans; Methods; Radiography; Simethicone; Sodium Bicarbonate