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Kim J, Chun S, Ohk SO, Kim S, Kim J, Lee S, Kim H, Kim S. Amelioration of alcohol‑induced gastric mucosa damage by oral administration of food‑polydeoxyribonucleotides. Mol Med Rep 2021; 24:790. [PMID: 34505634 PMCID: PMC8441963 DOI: 10.3892/mmr.2021.12430] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 07/28/2021] [Indexed: 11/16/2022] Open
Abstract
Gastritis refers to inflammation caused by injury to the gastric epithelium, which is usually due to excessive alcohol consumption and prolonged use of nonsteroidal anti-inflammatory drugs. Millions of individuals worldwide suffer from this disease. However, the lack of safe and promising treatments makes it urgent to explore and develop leads from natural resources. Therefore, food as medicine may be the best approach for the treatment of these disorders. The present study described the protective effects of food-polydeoxyribonucleotides (f-PDRNs) in a rat model of gastric mucosal injury induced by HCl-EtOH. Administration of f-PDRN was performed with low-PRF002 (26 mg/kg/day), medium-PRF002 (52 mg/kg/day) and high-PRF002 (78 mg/kg/day) on the day of autopsy. The site of damage to the mucous membrane was also analysed. In addition, an increase in gastric juice pH, total acidity of gastric juice and decrease in gastric juice secretion were confirmed, and gastric juice secretion-related factors corresponding to the administration of f-PDRN were analysed. Administration of f-PDRN reduced the mRNA expression of histamine H2 receptor, muscarinic acetylcholine receptor M3, cholecystokinin 2 receptor and H+/K+ ATPase related to gastric acid secretion and downregulation of histamine, myeloperoxidase and cyclic adenosine monophosphate. In addition, it was histologically confirmed that the loss of epithelial cells and the distortion of the mucosa were recovered in the group in which f-PDRN was administered compared to the model group with gastric mucosa damage. In summary, the present study suggested that f-PDRN has therapeutic potential and may have beneficial effects if taken regularly as a food supplement.
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Affiliation(s)
- Jonghwan Kim
- Technology Innovation Team, C&D Center, Pharma Research, Seongnam, Gyeonggi‑do 13486, Republic of Korea
| | - Soyoung Chun
- DNA Team, R&D Center, Pharma Research, Seongnam, Gyeonggi‑do 13486, Republic of Korea
| | - Seul-Ong Ohk
- DNA Team, R&D Center, Pharma Research, Seongnam, Gyeonggi‑do 13486, Republic of Korea
| | - Sanghoon Kim
- DNA Team, R&D Center, Pharma Research, Seongnam, Gyeonggi‑do 13486, Republic of Korea
| | - Juwan Kim
- Pharmaceutical Formulation Team, R&D Center, Pharma Research, Seongnam, Gyeonggi‑do 13486, Republic of Korea
| | - Sungoh Lee
- Research Strategy Team, C&D Center, Pharma Research, Seongnam, Gyeonggi‑do 13486, Republic of Korea
| | - Hangyu Kim
- DNA Team, R&D Center, Pharma Research, Seongnam, Gyeonggi‑do 13486, Republic of Korea
| | - Sujong Kim
- Research Strategy Team, C&D Center, Pharma Research, Seongnam, Gyeonggi‑do 13486, Republic of Korea
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Tjwa ETTL, Holster IL, Kuipers EJ. Endoscopic management of nonvariceal, nonulcer upper gastrointestinal bleeding. Gastroenterol Clin North Am 2014; 43:707-19. [PMID: 25440920 DOI: 10.1016/j.gtc.2014.08.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Upper gastrointestinal bleeding (UGIB) is the most common emergency condition in gastroenterology. Although peptic ulcer and esophagogastric varices are the predominant causes, other conditions account for up to 50% of UGIBs. These conditions, among others, include angiodysplasia, Dieulafoy and Mallory-Weiss lesions, gastric antral vascular ectasia, and Cameron lesions. Upper GI cancer as well as lesions of the biliary tract and pancreas may also result in severe UGIB. This article provides an overview of the endoscopic management of these lesions, including the role of novel therapeutic modalities such as hemostatic powder and over-the-scope-clips.
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Affiliation(s)
- Eric T T L Tjwa
- Department of Gastroenterology and Hepatology, Erasmus MC University Medical Centre, PO box 2040, 3000 CA, Rotterdam, The Netherlands.
| | - I Lisanne Holster
- Department of Gastroenterology and Hepatology, Erasmus MC University Medical Centre, PO box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Ernst J Kuipers
- Department of Gastroenterology and Hepatology, Erasmus MC University Medical Centre, PO box 2040, 3000 CA, Rotterdam, The Netherlands
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Tamura A, Murakami K, Kadota J. Prevalence of gastroduodenal ulcers/erosions in patients taking low-dose aspirin with either 15 mg/day of lansoprazole or 40 mg/day of famotidine: the OITA-GF study 2. BMC Res Notes 2013; 6:116. [PMID: 23531145 PMCID: PMC3626555 DOI: 10.1186/1756-0500-6-116] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2012] [Accepted: 03/20/2013] [Indexed: 12/27/2022] Open
Abstract
Background The preventive effects of histamine 2 receptor antagonists vs. proton pump inhibitors on low-dose aspirin (LDA)-related gastroduodenal mucosal injury have not been fully investigated. We conducted a cross-sectional study to compare the prevalence of gastroduodenal ulcers or erosions in patients taking LDA with either 40 mg/day of famotidine or 15 mg/day of lansoprazole for at least three months. Methods Of 84 eligible patients, two taking 40 mg/day of famotidine and four taking 15 mg/day of lansoprazole refused to undergo upper gastrointestinal endoscopy. Ultimately, we performed upper gastrointestinal endoscopy in 78 patients taking either 40 mg/day of famotidine (group F, n = 31) or 15 mg/day of lansoprazole (group L, n = 47). The prevalence of gastroduodenal ulcers or erosions and the magnitude of gastric mucosal injury evaluated using modified Lanza scores were compared between the two groups. Results No patients in either group had gastroduodenal ulcers. Gastroduodenal erosions were more prevalent in group F than in group L (48.4% vs. 17.0%, p = 0.005). The modified Lanza scores (mean ± SD) were significantly higher in group F than in group L (0.9 ± 1.3 vs. 0.3 ± 0.7, p = 0.007). A multivariate logistic regression analysis showed that the use of lansoprazole was negatively associated with gastroduodenal erosions. Conclusions This study suggests that 15 mg/day of lansoprazole may be more effective in preventing the development of LDA-related gastroduodenal erosions than 40 mg/day of famotidine. The preventive effects of these two regimens on the development of LDA-related gastroduodenal ulcers require further investigation.
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Affiliation(s)
- Akira Tamura
- Internal Medicine 2, Oita University, Yufu, Japan.
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Clinically significant endoscopic findings in a multi-ethnic population with uninvestigated dyspepsia. Dig Dis Sci 2012; 57:3205-12. [PMID: 22688184 DOI: 10.1007/s10620-012-2256-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2012] [Accepted: 05/15/2012] [Indexed: 12/16/2022]
Abstract
INTRODUCTION The proportion of clinically significant endoscopic findings (CSEF) in dyspepsia affects the initial management of this condition. With the changing epidemiology of organic upper gastrointestinal diseases in Asia, current data on CSEF remains uncertain. METHODS A cross-sectional study of consecutive adult patients attending an open access endoscopy list for the primary indication of dyspepsia was conducted. Independent epidemiological and clinical factors for CSEF were determined prospectively. RESULTS Data for 1167/1208 (96.6 %) adults (mean age 49.7 ± 15.9 years, 42.4 % males, ethnic distribution: 30.5 % Malays, 36.9 % Chinese and 30.8 % Indians) were analysed between January 2007 and August 2008. Three-hundred and eight (26.4 %) patients were found to have CSEF, most often those with age ≥45 years (30.3 vs 19 %, P < 0.0001), male gender (34.1 vs 20.7 % female, P < 0.0001), lower education levels (i.e. primary or no education), smoking (36.7 vs 24.9 %, P = 0.003), H. pylori infection (40.6 vs 21.8 %, P < 0.0001), and duration of dyspepsia ≤5 months (32.8 vs 24.4 %, P = 0.006). Age ≥ 45 years (OR 1.82, 95 % CI = 1.38-2.48), male gender (OR 1.84, 95 % CI = 1.53-2.59), H. pylori infection (OR 2.36, 95 % CI = 1.83-3.26), and duration of dyspepsia ≤5 months (OR 1.44, 95 % CI = 1.13-2.03) were subsequently identified as independent risk factors for CSEF. CONCLUSION CSEF are found in 26.4 % of Asian adults with uninvestigated dyspepsia. Duration of symptoms <5 months, among other recognised factors, is predictive of CSEF.
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Holster IL, Kuipers EJ. Management of acute nonvariceal upper gastrointestinal bleeding: current policies and future perspectives. World J Gastroenterol 2012; 18:1202-7. [PMID: 22468083 PMCID: PMC3309909 DOI: 10.3748/wjg.v18.i11.1202] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2011] [Revised: 05/30/2011] [Accepted: 06/06/2011] [Indexed: 02/06/2023] Open
Abstract
Acute upper gastrointestinal bleeding (UGIB) is a gastroenterological emergency with a mortality of 6%-13%. The vast majority of these bleeds are due to peptic ulcers. Nonsteroidal anti-inflammatory drugs and Helicobacter pylori are the main risk factors for peptic ulcer disease. Endoscopy has become the mainstay for diagnosis and treatment of acute UGIB, and is recommended within 24 h of presentation. Proton pump inhibitor (PPI) administration before endoscopy can downstage the bleeding lesion and reduce the need for endoscopic therapy, but has no effect on rebleeding, mortality and need for surgery. Endoscopic therapy should be undertaken for ulcers with high-risk stigmata, to reduce the risk of rebleeding. This can be done with a variety of modalities. High-dose PPI administration after endoscopy can prevent rebleeding and reduce the need for further intervention and mortality, particularly in patients with high-risk stigmata.
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Toljamo K, Niemelä S, Karvonen AL, Karttunen R, Karttunen TJ. Histopathology of gastric erosions. Association with etiological factors and chronicity. Helicobacter 2011; 16:444-51. [PMID: 22059395 DOI: 10.1111/j.1523-5378.2011.00871.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Abstract
BACKGROUND The histopathologic characteristics of the antral erosions, and a comparison with samples systematically collected from the background antral mucosa, have not been studied previously. Similarly, unknown is the association of these features with suspected etiological factors and chronicity of erosion. MATERIAL AND METHODS We studied 117 patients with gastric erosions in the absence of peptic ulcer disease. With 28 patients available for a follow-up 19 years later, sites of erosions and background mucosa were biopsied and histopathology of both independently assessed at both visits. Helicobacter pylori status was examined from the biopsies taken in the initial and follow-up gastroscopies. Only subjects originally displaying antral erosions were included. The presence of Herpes simplex virus (HSV) antibodies was analyzed and use of nonsteroidal anti-inflammatory drug (NSAID) was inquired. RESULTS Initially, the inflammation was more active in the region of erosions than elsewhere in antral mucosa. More active inflammation in the erosion was associated with HSV seropositivity, Helicobacter pylori infection, and the recent use of NSAIDs. In the follow-up visit, antral erosions were present in 38% (3/8) of Helicobacter pylori negatives and in 35% (7/20) of positives (p = ns). The Helicobacter pylori positive subjects with chronic or recurrent erosions had initially higher scores of neutrophils compared to subjects with nonrecurrent or nonchronic erosions (2.7 ± 0.5 vs 1.2 ± 1.0; p = .002). CONCLUSIONS Focally enhanced inflammation is characteristic for gastric erosions. This focal inflammation was associated with HSV seropositivity or NSAID use suggesting that such inflammation may be important in the pathogenesis of gastric antral erosions. Highly active inflammation in the erosions associates with their chronicity.
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Affiliation(s)
- Kari Toljamo
- Department of Internal Medicine, Division of Gastroenterology, University of Oulu, PL 5000, FI-90014 Oulu, Finland.
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Amano Y, Uno G, Yuki T, Okada M, Tada Y, Fukuba N, Ishimura N, Ishihara S, Kinoshita Y. Interobserver variation in the endoscopic diagnosis of gastroduodenal ulcer scars: implications for clinical management of NSAIDs users. BMC Res Notes 2011; 4:409. [PMID: 21996289 PMCID: PMC3208243 DOI: 10.1186/1756-0500-4-409] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2011] [Accepted: 10/13/2011] [Indexed: 01/10/2023] Open
Abstract
Background A clinical history of peptic ulcer has been reported to be associated with a high rate of ulcer recurrence in nonsteroidal anti-inflammatory drug (NSAID) users. Therefore, it is a very important issue to precisely know the previous history prior to NSAIDs administration. To clarify the possible difficulty to identify the history, we determined the sensitivity and diagnostic concordance of endoscopy for the identification of ulcer scars indicative of previous clinical history of peptic ulcer diseases. Methods The first study enrolled 200 consecutive patients with a clinical history of gastric or duodenal ulcers previously confirmed by esophagogastroduodenoscopy. The sensitivity of endoscopy for identifying scars was determined for these patients. In the second study, the extent of interobserver agreement was determined for 47 endoscopists who identified ulcer scars in endoscopic photographs of 30 sites of previous active gastric ulcers and 30 sites of previous active duodenal ulcers. The kappa coefficient of reliability was calculated to measure the interobserver agreement on the diagnosis of ulcer scars. Results Out of 190 patients eligible for analysis, 104 (54.7%) were found to have gastric or duodenal ulcer scars on endoscopy; there were no gastric or duodenal ulcer scars seen in the remaining patients (45%). In the second study, the kappa values for endoscopic diagnosis of gastric and duodenal ulcer scars were 0.14 (95% CI 0.13-0.16) and 0.29 (95% CI 0.27-0.32), respectively. The addition of indigo-carmine chromoendoscopy did not provide a statistically significant improvement in diagnostic concordance in patients with gastric ulcer scar since the kappa value for chromoendoscopic diagnosis was 0.15; 95% CI 0.13-0.17 as low as for un-contrasted scars. Conclusions The sensitivity and concordance of endoscopic diagnosis of gastric and duodenal ulcer scars are not satisfactory for the use of endoscopy only to identify previous ulcer disease. To avoid the overlooking the previous clinical history of peptic ulcer diseases, the diagnosis of peptic ulcer scar has to be carefully done prior to NSAIDs administration.
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Affiliation(s)
- Yuji Amano
- Division of Endoscopy, Shimane University Hospital, Izumo, Japan.
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Koskela RM, Niemelä SE, Lehtola JK, Bloigu RS, Karttunen TJ. Gastroduodenal mucosa in microscopic colitis. Scand J Gastroenterol 2011; 46:567-76. [PMID: 21291294 DOI: 10.3109/00365521.2011.551889] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND We have assessed gastroduodenal, endoscopical and histopathological findings in a series of patients with microscopic colitis (MC). METHODS We studied 75 patients with MC, 27 with collagenous colitis (CC) and 48 with lymphocytic colitis (LC), and 60 controls. Data of endoscopical findings were collected and biopsies were assessed. RESULTS Helicobacter pylori infection rate was 15% in MC and 28% in the controls (p = 0.088). Age at diagnosis of MC was higher in H. pylori positive than negative patients (63.4 ± 9.6 vs. 54.4 ± 13.1 years; p = 0.034). Gastric endoscopic erosions were more prevalent in CC than in LC (25.9% vs. 6.2%; p = 0.030) and associated with thick body glands and antral predominance of gastritis in H. pylori positive patients. Rates of focal gastritis (5.6% vs. 6.9%) and lymphocytic gastritis (5.6% vs. 10%) were similar in MC and controls. LC was associated with gastric epithelial lymphocytosis and lymphocytic gastritis. Fifteen patients (20%) had celiac disease. CONCLUSIONS Unlike LC, CC is associated with endoscopic erosions, likely related with the high acid secretion capacity as indicated by the ample body glands and antral predominance of gastritis in H. pylori associated cases of CC. The presence of some divergent gastroduodenal features in LC and CC, and in comparison with those reported in inflammatory bowel disease (IBD), supports the concept that these two conditions differ not only from IBD but also from each other. The findings also suggest the presence of pathogenetic links between colorectal and gastroduodenal abnormalities.
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Ma X, Zhao Y, Wang R, Yan X, Li Z, Zou D, He J. Epidemiology of gastroduodenal erosions in the general population: endoscopic results of the systematic investigation of gastrointestinal diseases in China (SILC). Scand J Gastroenterol 2010; 45:1416-23. [PMID: 20701433 DOI: 10.3109/00365521.2010.510570] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Population-based endoscopic studies of gastroduodenal erosions are limited in the world. This study describes features of gastroduodenal erosions in a representative sample of the population in Shanghai, China. MATERIAL AND METHODS A total of 3600 individuals (aged 18-80 years) were randomly selected from the Shanghai region and asked to undergo endoscopy and provide a blood sample to test for H. pylori infection. Participants completed a general information questionnaire, and a Chinese version of the Reflux Disease Questionnaire; 20% were also invited to complete the 36-item Short Form Health Survey and Epworth Sleepiness Scale. Associations between gastroduodenal erosions and other factors were analyzed using a multiple logistic regression model. RESULTS In total, 3153 individuals (87.6%) completed the survey and provided blood samples, 1030 (32.7%) agreed for endoscopy and 1022 participants were suitable for analysis. In all, 510 participants (49.9%) had gastroduodenal erosions (502 with gastric erosions; 26 with duodenal erosions). No significant association was found between H. pylori infection and gastroduodenal erosions. Increasing age, increasing BMI and current smoking were independent predictors for the presence of gastric erosions, but not of duodenal erosions. Duodenal erosions were more prevalent among men, which were not found in gastric erosions. The majority of individuals with gastroduodenal erosions were asymptomatic. CONCLUSIONS Gastroduodenal erosions are more common in China than in Europe, North America, and South America. No significant association was found between H. pylori infection and gastroduodenal erosions in China. The majority of individuals with gastroduodenal erosions were asymptomatic.
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Affiliation(s)
- Xiuqiang Ma
- Department of Health Statistics, Second Military Medical University, and Department of Gastroenterology, Changhai Hospital, Shanghai, China
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Helicobacter pylori status and esophagogastroduodenal mucosal lesions in patients with end-stage renal failure on maintenance hemodialysis. J Gastroenterol 2010; 45:515-22. [PMID: 20084526 DOI: 10.1007/s00535-009-0196-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2009] [Accepted: 12/15/2009] [Indexed: 02/04/2023]
Abstract
OBJECTIVES The aim of this study was to elucidate the impact of Helicobacter pylori infection on esophagogastroduodenal mucosal lesions in patients with end-stage renal failure on maintenance hemodialysis (HD). METHODS An upper endoscopy and the (13)C-urea breath test were performed in 198 patients on maintenance HD. Clinical features, serum pepsinogen levels and esophagogastroduodenal mucosal lesions were compared between H. pylori-positive and H. pylori-negative patients. Risk factors associated with esophagogastroduodenal mucosal lesion were determined by multivariate analyses. RESULTS The upper endoscopy revealed that gastric erosion was the most frequent (58%) type of esophagogastroduodenal mucosal lesion, followed by duodenal erosion (18%), gastric ulcer (14%), gastroesophageal reflux disease (10%), and duodenal ulcer (7%). Of the 198 patients enrolled in the study, 81 were positive and 117 patients were negative for H. pylori infection. The time duration after the introduction of HD was significantly longer and serum pepsinogen I/II ratio was significantly higher in H. pylori-negative patients than in H. pylori-positive patients. Multivariate analyses revealed that the H. pylori infection was an independent, protective factor for gastric erosion (odds ratio 0.38; 95% confidence interval 0.21-0.70), while the infection was unrelated to other mucosal lesions. CONCLUSIONS The most common mucosal lesion observed in our study cohort, all of whom were patients on maintenance HD, was gastric erosion. The high prevalence of this type of lesion may be explained partly by the cure of H. pylori infection during the clinical course of maintenance HD.
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Risk factors for the development of gastric mucosal lesions in rheumatoid arthritis patients receiving long-term nonsteroidal anti-inflammatory drug therapy and the efficacy of famotidine obtained from the FORCE study. Mod Rheumatol 2010; 19:629-36. [PMID: 19728013 DOI: 10.1007/s10165-009-0202-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2008] [Accepted: 06/19/2009] [Indexed: 10/20/2022]
Abstract
The objective of this study was to investigate the prevalence of gastric mucosal injury induced by nonsteroidal anti-inflammatory drugs (NSAIDs) in patients with rheumatoid arthritis (RA). Upper gastrointestinal endoscopy was performed on 100 RA patients treated with NSAIDs. Patient factors potentially contributing to the development of NSAID-induced gastric mucosal injury were identified by logistic regression analysis; gastric mucosal injury and ulcers were used as objective variables. Gastric mucosal injury was detected in 62 of 100 patients, and eight of these patients had ulcers. Previous history of ulcers, lifestyle, NSAID dosage, and body mass index were associated with the development of gastric mucosal injury,and the use of diclofenac and steroid dose were associated with the development of ulcers. Disease-modifying antirheumatic drugs (DMARDs) did not appear to influence the risk of NSAID-induced gastric mucosal injury. RA patients treated for long periods with NSAIDs for RA symptoms should be controlled with DMARDs, without consideration of increased doses of steroids, in terms of risk for NSAID-induced gastric mucosal injury. Simultaneously, concomitant use of histamine-2 receptor antagonists (H2RA) such as famotidine should be considered.
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Oksanen A, Veijola L, Korudanova B, Sipponen P, Sarna S, Rautelin H. Role of earlier gastroscopy in predicting findings on repeat gastroscopy in a population with a low H. pylori prevalence. Scand J Gastroenterol 2008; 43:1044-9. [PMID: 18609178 DOI: 10.1080/00365520802078333] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Repeat gastroscopy is not recommended for patients without alarm symptoms and with a normal earlier gastroscopy. However, there is little information available on the consequences of this recommendation. The objective of this study was to examine the role of earlier gastroscopy results in predicting the findings at repeat gastroscopy. MATERIAL AND METHODS Patients with previous gastroscopies presenting for a new gastroscopy during 2004-05 were included consecutively. A total of 293 patients who had undergone a gastroscopy a mean of 7.7 years (range 0.6-25.4 years) before the present gastroscopy were included in the study. The patients completed a questionnaire. The associations between the findings of the present gastroscopy and the findings of the previous gastroscopy and other patient characteristics were analysed by stepwise logistic regression. RESULTS Nine percent of the patients were positive for Helicobacter pylori infection. An abnormal macroscopic finding, defined as any erosion, ulcer or other macroscopic finding with the exception of hiatus hernia, at the repeat gastroscopy was significantly positively associated with: 1) an abnormal finding at a previous gastroscopy (OR 2.94, 95% CI 1.48-5.85), 2) obesity (body mass index, BMI >30) (OR 2.89, 95% CI 1.28-6.55), 3) the presence of alarm symptoms (OR 2.68, 95% CI 1.29-5.56), and negatively associated with 4) the use of proton pump inhibitors (OR 0.48, 95% CI 0.24-0.98). The findings were not associated with age. CONCLUSIONS Abnormal earlier gastroscopy findings, obesity and the presence of alarm symptoms were the strongest indicators of abnormal findings at repeat gastroscopy. Our results support a restrained gastroscopy policy in patients with no alarm symptoms and a normal earlier gastroscopy.
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Affiliation(s)
- Aino Oksanen
- Herttoniemi Municipal Hospital, Health Centre, City of Helsinki
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Should patients with pH-documented laryngopharyngeal reflux routinely undergo oesophagogastroduodenoscopy? A retrospective analysis. The Journal of Laryngology & Otology 2007; 121:1165-9. [DOI: 10.1017/s0022215107000680] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
AbstractObjectives:Patients with laryngopharyngeal reflux uncommonly suffer from conditions associated with gastroesophageal reflux disease. However, in some laryngopharyngeal reflux patients, oesophagitis and Barrett's metaplasia can be diagnosed by oesophagogastroduodenoscopy. However, it is unclear which patients with laryngopharyngeal reflux would benefit from routine oesophagogastroduodenoscopy.Study design:Retrospective analysis.Materials and methods:Analysis of the results of oesophagogastroduodenoscopy in 28 patients with pH-documented laryngopharyngeal reflux.Results:Oesophagogastroduodenoscopy showed oesophagitis in five patients (four with grade A, one with grade B), hiatus hernia in 10 patients (36 per cent), Barrett's metaplasia in two patients, Helicobacter pylori-associated chronic gastritis in two patients and gastric mucosal erosions in seven patients (25 per cent). In 13 patients, no abnormalities were detected (46 per cent). Barrett's metaplasia or grade B oesophagitis was diagnosed only in patients with heartburn as their main presenting symptom.Conclusions:Oesophagogastroduodenoscopy is indicated in at least those laryngopharyngeal reflux patients reporting heartburn as their main complaint.
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