sodium-bicarbonate and Esophagitis

Both proton pump inhibitor drug treatment and Helicobacter pylori infection cause hypergastrinaemia in man.. To determine whether eradicating H pylori is a means of reducing hypergastrinaemia during subsequent proton pump inhibitor treatment.. Patients with H pylori were randomised to treatment with either anti-H pylori or symptomatic treatment. One month later, all received four weeks treatment with omeprazole 40 mg/day for one month followed by 20 mg/day for six months. Serum gastrin concentrations were measured before and following each treatment.. In the patients randomised to anti-H pylori treatment, eradication of the infection lowered median fasting gastrin by 48% and meal stimulated gastrin by 46%. When gastrin concentrations one month following anti-H pylori/symptomatic treatment were used as baseline, omeprazole treatment produced a similar percentage increase in serum gastrin in the H pylori infected and H pylori eradicated patients. Consequently, in the patients in which H pylori was not eradicated, median fasting gastrin concentration was 38 ng/l (range 26-86) at initial presentation and increased to 64 ng/l (range 29-271) after seven months omeprazole, representing a median increase of 68% (p < 0.005). In contrast, in the patients randomised to H pylori eradication, median fasting gastrin at initial presentation was 54 ng/l (range 17-226) and was unchanged after seven months omeprazole at 38 ng/l (range 17-95).. Eradicating H pylori is a means of reducing the rise in gastrin during subsequent long term omeprazole treatment. In view of the potential deleterious effects of hypergastrinaemia it may be appropriate to render patients H pylori negative prior to commencing long-term proton pump inhibitor treatment.

Topics: Adult; Alginates; Aluminum Hydroxide; Amoxicillin; Antacids; Anti-Ulcer Agents; Drug Combinations; Drug Therapy, Combination; Esophagitis; Female; Gastrins; Gastroscopy; Helicobacter Infections; Helicobacter pylori; Humans; Male; Metronidazole; Middle Aged; Omeprazole; Organometallic Compounds; Peptic Ulcer; Silicic Acid; Sodium Bicarbonate

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

Standard treatment for locally advanced non-small cell lung cancer (LA-NSCLC) is concomitant chemoradiotherapy. The survival benefit of combined treatment is partially counterbalanced by an increased rate of acute esophageal toxicity. Several pharmaceutical products are available for prevention and management of esophagitis, including Faringel Plus.. To assess the incidence and the grade, identify the correlations with clinical, dosimetric, and therapeutic variables, and analyse the role of Faringel Plus as a pharmaceutical preventive measure against acute esophageal toxicity.. Patients with LA-NSCLC treated with concomitant radiochemotherapy were retrospectively reviewed. Acute esophagitis and dysphagia were graded according to Common Terminology Criteria for Adverse Events version 5.0. Clinical, dosimetric, and therapeutic correlations were investigated using χ. Among the 23 analysed patients, 18 (78.3%) and 1 (4.3%) developed G2 and G3 esophagitis, respectively; G1-2 dysphagia were reported in 11 cases (47.8%). No statistically significant correlation between the variables considered and acute esophageal toxicity was identified. In the group of patients who received Faringel Plus as preventive treatment (10 subjects, 43.5%), dysphagia presentation time was significantly longer (. Acute mild esophageal toxicity was confirmed to be a common side effect in this setting. No clinical-dosimetric parameter has been demonstrated to be effective in predicting acute esophageal toxicity. The use of Faringel Plus appears effective as a therapeutic and prophylactic tool to manage acute esophageal toxicity.

Topics: Alginates; Biological Products; Carcinoma, Non-Small-Cell Lung; Chemoradiotherapy; Deglutition Disorders; Esophagitis; Humans; Lung Neoplasms; Pharmaceutical Preparations; Radiation Injuries; Retrospective Studies; Sodium Bicarbonate

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