BACKGROUND: The pathogenesis of @entity354 is not well understood and remains controversial. Distal gastrectomy serves as a model to assess the role of duodenal reflux with low gastric acidity in the development of @entity354 . We investigated the clinical usefulness and antitrypsin activity after treatment with a trypsin inhibitor, @entity12340 , against the @entity354 after distal gastrectomy reconstructed with Billroth-I @entity254 . METHODS: Twenty-eight @entity1 with @entity354 after distal gastrectomy were prescreened according to esophageal pH level and trypsin activity, and consequently 11 @entity1 were enrolled in the present clinical study. Esophageal and duodenal washings were aspirated for the evaluation of the pretreatment trypsin activity. Then 100 mg of @entity12340 was administered orally. At 30 and 120 minutes after the administration, duodenal washings were aspirated for the evaluation of posttreatment trypsin activity. Thereafter, 300 mg of @entity12340 was administered orally 3 times daily for a 4-week period. On the 28th day of administration, the grade of @entity354 (Los Angeles classification) was re-evaluated under endoscopy and the esophageal washings were aspirated for the evaluation of trypsin activity. RESULTS: The trypsin activities in the duodenum both at 30 and 120 minutes after oral ingestion of @entity12340 were decreased significantly in comparison with those in the pretreatment period in each @entity1 (P<.001). In 6 of 7 @entity1 with detectable trypsin activity in the esophagus, the activities after the 28th day of treatment were lower than those in the pretreatment period, and the symptoms were milder than those before treatment (P<.05). Furthermore, endoscopic evaluation showed that 40% of @entity1 were grade B, C, and D after treatment (28th day), whereas 70% of @entity1 were grade B, C, and D before the treatment. CONCLUSIONS: Oral administration of trypsin inhibitor can improve @entity354 after distal gastrectomy concomitant with decreased trypsin activity.

Oral trypsin inhibitor can improve XXXX after distal gastrectomy concomitant with decreased trypsin activity.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity254 :: ('MESH:C563598', 'Disease') :: ['anastomosis'] @entity12340 :: ('MESH:C034532', 'Chemical') :: ['camostat mesilate'] @entity354 :: ('MESH:D005764', 'Disease') :: ['gastroesophageal reflux disease', 'reflux esophagitis']
@entity354 :: (MESH:D005764,Disease) :: ['reflux esophagitis']
