bluuebunny/crossref_metadata_2025_split huggingface dataset:
Review article: non‐steroidal, antiinflammatory drugs—the extending scope of gastrointestinal side effects
Authors: AABAKKEN L. 
Published: July 2010

SUMMARYThe gastrointestinal side effects of non‐steroidal, anti‐inflammatory drugs extend beyond the duodenal bulb, and comprise a variety of lesions in all parts of the gut. Gastroduodenal ulceration is quantitatively dominant, although a major part of these lesions probably go unnoticed and heal spontaneously. Adaptation has been demonstrated for acetylsalicylic acid, and may be of importance for other substances as well. Non‐steroidal anti‐inflammatory drugs (NSAIDs) may induce relapse of inflammatory bowel disease. Permeability changes and mucosal inflammation are found in the small and large bowel in the majority of subjects taking NSAIDs, although the clinical significance is still not clear. Ulceration and perforation do, however, occur in this part of the gut as well. Treatment of NSAID‐associated ulceration is similar to traditional ulcer treatment, possibly with extended treatment duration if the NSAID is continued. Prophylaxis is of some value, but is not required for every patient receiving an NSAID.
Short report: the effect of ranitidine on the post‐prandial absorption of a low dose of alcohol
Authors: FRASER A. G. , HUDSON M. , SAWYERR A. M. , ROSALKI S. B. , POUNDER R. E. 
Published: July 2010

SUMMARYTwenty healthy male subjects were studied twice using a double‐blind, randomized placebo controlled, cross‐over study design. Alcohol absorption (integrated 2‐h plasma alcohol concentration, peak plasma alcohol concentration, and time to reach peak concentration) was measured after 8 daily doses of either placebo or 300 mg ranitidine. They were given alcohol, 0.15 g/kg of body weight by month after an evening meal. Compared with placebo, there was a trend towards higher integrated 2‐h plasma alcohol concentrations (3.17 and 3.89 mg. h/dL, respectively, P= 0.07), and a statistically significant increase in mean peak plasma alcohol concentration after dosing with ranitidine (4.92 and 6.47 mg/dL, respectively, P= 0.05).
Review article: maintenance treatment with H2‐receptor antagonists for peptic ulcer disease
Authors: PENSTON J. G. , WORMSLEY K. G. 
Published: July 2010

SUMMARYIn recent years a number of different strategies for managing patients with peptic ulcer disease have become available. The present review discusses the relative merits of each form of treatment. Intermittent treatment (whether given in response to symptoms or as a prophylactic regimen prescribed seasonally or at weekends) fails to prevent ulcer recurrence and leaves patients at risk of haemorrhage and perforation. Anti‐Helicobacter pylori therapy, although useful in certain circumstances, cannot be recommended for all patients with ulcer disease because of side effects and, in any case, requires further assessment of efficacy. Gastric surgery reduces ulcer recurrence and complications, but operations which have a low incidence of side effects are associated with higher rates of ulcer recurrence, particularly when patients are followed up for more than 10 years. Long‐term continuous maintenance treatment with H2‐receptor antagonists for 5 or more years effectively prevents ulcer recurrence in the majority of patients and significantly reduces the risk of ulcer complications. In addition, maintenance treatment has proved to be safe and is well tolerated by patients.Maintenance treatment with H2‐receptor antagonists is the preferred option for the management of patients with peptic ulcer disease.
Clinical tolerance to three 5‐aminosalicylic acid releasing preparations in patients with inflammatory bowel disease intolerant or allergic to sulphasalazine
Authors: GIAFFER M. H. , O'BRIEN C. J. , HOLDSWORTH C. D. 
Published: July 2010

SUMMARYThe clinical tolerance to three 5‐aminosalicylic acid (5‐ASA) releasing preparations (mesalazine, olsalazine and balsalazide) was assessed in a consecutive series of 43 patients with inflammatory bowel disease who were intolerant to sulphasalazine. The relative contributions to the side‐effects of sulphasalazine made by its two components, 5‐ASA and sulphapyridine, were also assessed in these patients. Thirty‐nine (91%) patients were able to tolerate at least one of the three 5‐ASA preparations. Only four (9%) patients were intolerant to all preparations, having adverse reactions previously experienced with sulphasalazine and presumably related to 5‐ASA rather than sulphapyridine. The clinical tolerance to mesalazine (63%), olsalazine (70%) and balsalazide (70%) was similar, and tolerance to one drug only was found in nine (18%) patients. The commonest adverse reactions associated with 5‐ASA preparations were gastrointestinal. Diarrhoea was a problem in five patients during treatment with olsalazine and three each while on mesalazine and balsalazide. Allergic reactions from 5‐ASA preparations were uncommon; of ten patients with rash following sulphasalazine only one developed a rash with mesalazine. The results of this study indicate that the vast majority of patients with inflammatory bowel disease can be managed with at least one of these four 5‐ASA containing preparations and that the side‐effects of sulphasalazine are multifactorial in aetiology, some being due to the parent molecule, and some to one of its two metabolites, 5‐ASA and sulphapyridine.
Lansoprazole versus famotidine: efficacy and tolerance in the acute management of duodenal ulceration
Authors: HOTZ J. , KLEINERT R. , GRYMBOWSKI T. , HENNIG U. , SCHWARZ J. A. 
Published: July 2010

SUMMARYLansoprazole (AG 1749/CG 4801) is an inhibitor of gastric acid secretion by blocking H+,K+‐ATPase. In this 2:1 randomized, double‐blind, multicentre trial lansoprazole 30 mg am was compared to 40 mg famotidine nocte in 264 out‐patients suffering from uncomplicated duodenal ulcer. After 2 weeks of treatment ulcer healing was confirmed endoscopically in a significantly higher proportion (P= 0.027) of patients treated with lansoprazole (94/174 = 54.0%) compared to patients receiving famotidine (35/90 = 38.9%). Cumulative healing rates after 4 weeks were 91.4% for the lansoprazole group and 83.3% for the famotidine group (P= 0.065). Pain relief and decrease of concomitant antacid consumption during treatment were comparable in both groups. Both compounds were well tolerated. Rates of recurrent duodenal ulcer in the 6 months after trial treatment were 45/158 (28.5%) after lansoprazole, and 18/69 (26.1%) after famotidine.
Omeprazole (20 mg) daily given in the morning or evening: a comparison of effects on gastric acidity, and plasma gastrin and omeprazole concentration
Authors: CHIVERTON S. G. , HOWDEN C. W. , BURGET D. W. , HUNT R. H. 
Published: July 2010

SUMMARYAlthough omeprazole has a long duration of action and has usually been given in the morning, there are theoretical advantages in administering antisecretory drugs in the evening as has been shown for the H2‐receptor antagonists. The aim of this study was to compare the effects of placebo and 20 mg omeprazole given either in the morning or evening, on gastric acidity, plasma gastrin levels and plasma omeprazole in 6 duodenal ulcer patients. The 24‐hour mean pH (± S.E.M.) was: placebo 1.7 ± 0.1; morning doing, 3.9 ± 1.8 (P < 0.01); evening dosing, 2.9 ± 1.1 (N.S.). There was a large inter‐individual variability of intragastric acidity in response to omeprazole, which was reflected both in the plasma gastrin and in the area under the plasma omeprazole concentration–time curve. Morning administration of omeprazole is optimal, but variability in the patient response to 20 mg omeprazole is still seen.
Short report: short‐term triple therapy for H. pylori‐associated duodenal ulcer disease
Authors: PATCHETT S. , BEATTIE S. , KEANE C. , O'MORAIN C. 
Published: July 2010

SUMMARYThirty consecutive patients with endoscopically proven duodenal ulceration who had Helicobacter pylori infection on culture and histology, were treated with tripotassium dicitrato bismuthate (1 tablet q.d.s., 400 mg metronidazole t.d.s. and 500 mg tetracycline t.d.s. for one week, followed by the bismuth salt for a further 3 weeks. All patients were endoscoped at entry and 4 weeks after cessation of treatment, to check for ulcer healing and H. pylori eradication. Two antral biopsies were taken at each endoscopy for histological and microbiological evidence of H. pylori infection. Complete healing of duodenal ulcers was observed in 27/30 patients (90%). Gastritis improved or completely resolved in 26 patients. Eradication of H. pylori was achieved in 27 patients. Of the three patients who failed to heal, two were H. pylori‐positive at follow‐up and one was H. pylori‐negative.
Helicobacter pylori clearance in the treatment of non‐ulcer dyspepsia
Authors: HOLCOMBE C. , THOM C. , KALUBA J. , LUCAS S. B. 
Published: July 2010

SUMMARYOne hundred and thirty north Nigerian patients with non‐ulcer dyspepsia were treated with tripotassium dicitrato bismuthate and amoxycillin, or antacid. Symptoms resolved in 28 (33%) of bismuth and amoxycillin recipients completing the trial compared with 1 (4%) of the antacid recipients. Symptomatic improvement did not relate to clearance of Helicobacter pylori.
The effect of alpha‐1‐adrenoreceptor agonist and antagonist administration on kumun upper gastrointestinal transit and motility
Authors: McINTYRE A. S. , THOMPSON D. G. , BURNHAM W. R. , WALKER E. 
Published: July 2010

SUMMARYTo explore the role of alpha‐1‐adrenoreceptor‐mediated pathways on human upper gut motor function in vivo, we studied the effects of the alpha‐1‐agonist phenylephrine and the alpha‐1‐antagonist thymoxamine on oro‐caecal transit and antroduodenal motor activity. Transit was measured using a standard exhaled‐breath hydrogen method, and motility was measured by intraluminal manometry.Oro‐caecal transit was unaffected by 80 mg thymoxamine [median 63 min (range 35–164 min) vs. control, 65 min (range 30–155 min), P > 0.1]. However, phenylephrine (2.4 μg/kg/min) consistently delayed oro‐caecal transit time to 103 min (50–215 min), P > 0.005. Co‐administration of thymoxamine abolished this phenylephrine‐induced delay.The mean amplitude of antral postprandial contractions was reduced by phenylephrine from 29 (13–37) to 10 (3–13) mmHg (P < 0.02). In contrast, neither the pattern nor the mean inter‐contraction interval was altered. Responses to phenylephrine in the duodenum were similar to those in the antrum, with reduction in amplitude from 12 (3–18) to 6 (5–13) mmHg without alteration in the pattern or interval between contractions.Nutrient transit through the upper gut can thus be inhibited via activation of an alpha‐1‐adrenoreceptor‐mediated pathway. Failure of alpha‐1‐antagonist administration to alter oro‐caecal transit suggests that this pathway is not tonically active, and it is therefore unlikely to play a major role in nutrient passage under normal circumstances.
Experience with‘triple’ anti‐Helicobacter pylori eradication therapy: side effects and the importance of testing the pre‐treatment bacterial isolate for metronidazole resistance
Authors: BELL G. D. , POWELL K. , BURRIDGE S. M. , PALLECAROS A. , JONES P. H. , GANT P. W. , HARRISON G. , TROWELL J. E. 
Published: July 2010

SUMMARYAt the 1990 World Congresses of Gastroenterology, the Working Party on Helicobacter pylori (H. pylori) recommended that, in suitable patients, the bacterium should be eradicated using a therapeutic regimen comprising a bismuth salt, tetracycline and metronidazole for two weeks. We have treated 40 patients infected with H. pylori with‘triple’ therapy consisting of 120 mg tripotassium dicitrato bismuthate q.d.s., 500 mg tetracycline q.d.s. and 400 mg metronidazole t.d.s. for two weeks.The success rate, in terms of bacterial eradication, was 19/21 (90.5%) in patients with metronidazole‐sensitive organisms, compared with only 6/19 (31.6%) in patients whose H. pylori were resistant to metronidazole (P < 0.01). Side effects, particularly diarrhoea and vomiting/nausea, were common: 23/40 patients reported such symptoms during the 14‐day course of therapy. Fifteen of these 23 patients completed the entire 14‐day course, although suffering from significant side effects, while the remaining eight patients had to discontinue the treatment because side effects became intolerable.If a form of triple therapy is going to be widely used to eradicate H. pylori infection, the regimen will have to be simpler, shorter, produce fewer side effects and be more effective in patients with metronidazole‐resistant bacteria.
An artificial stomach‐duodenum model for the in‐vitro evaluation of antacids
Authors: VATIER J. , MALIKOVA‐SEKERA E. , VITRE M. T. , MIGNON M. 
Published: July 2010

SUMMARYTo improve the dynamic in‐vitro evaluation of the effects of antacids, we have developed the‘artificial stomach’ model by adding a‘duodenal reservoir’ to receive the gastric emptying flux and simulated bicarbonate secretion, thus constituting an‘artificial stomach‐duodenum’ model. With this model we measured antacid‐induced resistance to gastric acidification, and simultaneously evaluated the effect of antacid activity on the duodenal milieu. The model also permitted evaluation of the antacid effects of proteins (as natural antacids), and of drugs containing aluminium phosphate, alone or combined with magnesium oxide, or aluminium and magnesium hydroxides. At the gastric site, these drugs, as well as the proteins (that is, meat extract), induced a strong resistance to acidification due to the gastric emptying flux and to antacid composition. At the duodenal site, the decrease of the acid load penetrating into the duodenum varied, depending on the efficacy of gastric antacid activity. Duodenal pH was related to the equilibrium between bicarbonate secretion and the emptying of acid load. Proteins and aluminium phosphate induced the same duodenal pH as in the control tests without antacids, but magnesium‐containing antacids increased it, thus decreasing bicarbonate consumption. The antacid mechanisms within the stomach, and the fate of antacids in the duodenal milieu, might explain the variation in duodenal pH in response to antacid administration.
Treatment of Crohn's disease with fusidic acid: an antibiotic with immunosuppressive properties similar to cyclosporin
Authors: LANGHOLZ E. , BRYNSKOV J. , BENDTZEN K. , VILIEN M. , BINDER V. 
Published: July 2010

SUMMARYFusidic acid is an antibiotic with T‐cell specific immunosuppressive effects similar to those of cylosporin. Because of the need for the development of new treatments for Crohn's disease, a pilot study was undertaken to estimate the pharmacodynamics and tolerability of fusidic acid treatment in chronic active, therapy‐resistant patients. Eight Crohn's disease patients were included. Fusidic acid was administered orally in a dose of 500 mg t.d.s. and the treatment was planned to last 8 weeks. The disease activity was primarily measured by a modified individual grading score. Five of 8 patients (63%) improved during fusidic acid treatment: 3 at two weeks and 2 after four weeks. There were no serious clinical side effects, but dose reduction was required in two patients because of nausea, Biochemically, an increase in alkaline phosphatases was noted in 5 of 8 cases (63%), and the greatest increases were seen in those who had elevated levels prior to treatment. All reversed to pre‐treatment levels after cessation of treatment.The results of this pilot study suggest that fusidic acid may be of benefit in selected chronic active Crohn's disease patients in whom conventional treatment is ineffective. Because there seems to exist a scientific rationale for the use of fusidic acid at the cytokine level in inflammatory bowel disease, we suggest that the role of this treatment should be further investigated.
Short report: comparison of two orally administered bowel preparations for colonoscopy—polyethylene glycol and sodium picosulphate
Authors: DAKKAK M. , AZIZ K. , BENNETT J. R. 
Published: July 2010

SUMMARYFifty‐nine consecutive patients admitted for colonoscopy were randomized to receive polyethylene glycol or sodium picosulphate. Patients expressed their opinion in a questionnaire and the endoscopists, blinded to the preparation, assessed the cleanliness of different segments of the colon.There was no statistically significant difference in the taste‐acceptability of the preparations, frequency of nausea, abdominal pain, peri‐anal soreness or sleep disturbance between the two groups. Polyethylene glycol caused vomiting in 13% of patients while this was absent in those who received sodium picosulphate (P< 0.05).The average number of stools passed was 12.4 in the polyethylene glycol and 8.6 in the sodium picosulphate groups; mean difference 3.8 (95% C.I. 0.7–6.9) withP< 0.02. The overall cleanliness of the colon was better in the polyethylene glycol group (P= 0.002) as judged by the blinded colonoscopist. There was less delay (P= 0.06) and more completed colonoscopies (P= 0.01) in this group. Polyethylene glycol was a better preparation in all segments of the colon except the rectum.We conclude that polyethylene glycol is the choice of the colonoscopist and should be given to all patients; sodium picosulphate would be a good alternative if patients are intolerant. If a limited colonoscopy or flexible sigmoidoscopy is intended, sodium picosulphate may be preferred because of its acceptable efficacy and slightly advantageous side‐effect profile.
Review article: the pathophysiology and pharmacological treatment of portal hypertension
Authors: GROSE R. D. , HAYES P. C. 
Published: July 2010

SUMMARYThe pathogenesis of portal hypertension remains poorly understood. Similarly, pharmacological manipulation for the prevention and treatment of variceal haemorrhage has not fulfilled the promise of the 1980s. This article reviews current concepts in the pathophysiology of portal hypertension and considers pharmacotherapy for the treatment of variceal bleeding.
A comparison of gastro‐oesophageal reflux in volunteers assessed by ambulatory pH and gamma monitoring after treatment with either Liquid Gaviscon or Algicon Suspension
Authors: WASHINGTON N. , GREAVES J. L. , IFTIKHAR S. Y. 
Published: July 2010

SUMMARYThis study was designed to compare the effectiveness of single doses of either Liquid Gaviscon or Algicon Suspension in the suppression of food and acid reflux into the oesophagus after a test meal in volunteers.After the pH electrode and gamma detector were positioned 5 cm above the cardia, the volunteers received a refluxogenic radiolabelled meal. The subjects then remained untreated, or thirty minutes later they were given a dose of unlabelled Algicon Suspension, or Liquid Gaviscon and a recording was made for a minimum of 3 hours. Allocation to the treatment group was randomized with the cross‐overs performed 1 week apart.Liquid Gaviscon suppressed gastro‐oesophageal reflux of both food and acid whereas only an insignificant reduction in reflux was seen after Algicon Suspension. The oesophageal pH remained below 4 for 3.21 ± 0.92% (S.E.M.) of the recording period in the control study, 0.88 ± 0.33 after Gaviscon and 2.91 ± 0.68 after Algicon. The reflux of food was reduced from 17070 ± 103± 4713 ± 103 counts in the control study to 224 ± 103± 93 ± 103 counts after the Gaviscon and 16080 ± 103± 7131 ± 103 counts after Algicon. The suppression of reflux by Liquid Gaviscon was significantly better than that produced by Algicon Suspension.
A new model of human secretory diarrhoea using cholera toxin
Authors: HUNT J. B. , THILLAINAYAGAM A. V. , CARNABY S. , FAIRCLOUGH P. D. , CLARK M. L. , FARTHING M. J. G. 
Published: July 2010

SUMMARYSecretory diarrhoea is a major cause of morbidity and mortality worldwide. However, there is no biologically relevant test system in man for assessing new anti‐diarrhoeal therapies prior to clinical trial. We have used highly purified cholera toxin in combination with the triple lumen jejunal perfusion technique to establish a subclinical model of cholera in man. Cholera toxin was administered either by mouth with sodium bicarbonate or directly into a 30 cm‘open’ or‘closed’(isolated between two inflated balloons) jejunal segment in healthy adult volunteers. Both oral dosing and direct delivery into an‘open’ jejunal segment failed to produce consistent secretion of water and electrolytes. In contrast 15 μg or 25 μg of cholera toxin elicited secretion of water and sodium 3 h after instillation into the balloon occluded‘closed’ jejunal segment (P < 0.05 vs. controls). The rate of secretion was constant over the maximal period studied (4.5 h) and was similar to that reported in human cholera. None of the subjects experienced troublesome diarrhoea. We believe this model offers a relevant test system for assessing anti‐diarrhoeal therapy in man.
Ranitidine: differential effects on gastric bleeding and mucosal damage induced by aspirin
Authors: COLE A. T. , BRUNDELL S. , HUDSON N. , HAWTHORNE A. B. , MAHIDA Y. R. , HAWKEY C. J. 
Published: July 2010

SUMMARYThis study investigated the influence of ranitidine on mucosal injury and gastric bleeding in 20 normal volunteers taking 600 mg aspirin q.d.s. This study was a double‐blind placebo controlled crossover study comparing ranitidine, as 150 mg b.d., 300 mg q.d.s. and 600 mg b.d. with placebo. Gastric mucosal injury was assessed at unsedated endoscopy by counting haemorrhagic and non‐haemorrhagic erosions; bleeding was measured in gastric washings. Aspirin alone increased mucosal injury from 0 to 11.4 erosions (mean, P < 0.01) and bleeding from 1.77 to 9.11 μl blood/10 min (mean P < 0.001). Ranitidine prophylaxis reduced bleeding to 5.34, 3.18 and 3.47 μl/10 min with 150 mg b.d., 300 mg q.d.s. and 600 mg b.d. respectively (overall effect of ranitidine P < 0.001) and also reduced haemorrhagic erosions though it had no effect on the total number of erosions. Ranitidine is effective at reducing aspirininduced gastric bleeding and whilst not reducing aspirin‐induced gastric erosions, it does reduce the number that appear haemorrhagic. Ranitidine may have a role in the prophylaxis of aspirin‐induced gastric bleeding.
Is oropharyngeal anaesthesia with topical lignocaine useful in upper gastrointestinal endoscopy?
Authors: JAMESON J. S. , KAPADIA S. A. , POLSON R. J. , McCARTHY P. T. , MISIEWICZ J. J. 
Published: July 2010

SUMMARYThe aim of this study was to determine whether patients' tolerance of upper gastrointestinal endoscopy is related to the dose of lignocaine spray used for oropharyngeal anaesthesia and to measure plasma concentrations at these doses. Sixty consecutive patients undergoing routine upper gastrointestinal endoscopy with sedation were randomized to receive lignocaine spray 50 mg (Group A), 100 mg (Group B) or 200 mg (Group C). Patient, endoscopist and endoscopy nurse were unaware of the variation in dose used. Each patient's tolerance of the intubation and of the remainder of the gastroscopy was assessed independently by the patient, endoscopy nurse, and endoscopist using a visual analogue scale. Plasma lignocaine concentration was measured at 20, 40, 60 and 80 min after administration of the spray. Fifty (83 %) patients were unable to recall either the intubation, or the procedure. On the endoscopy nurse's assessment, the patients in Group B tolerated the intubation better than those in Group A, and Groups B and C tolerated the remainder of the gastroscopy better than those in Group A. On the endoscopist's assessment, Groups B and C tolerated the remainder of the gastroscopy better than Group A. There were fewer gags per min in Groups B and C compared to Group A. Mean plasma Lignocaine concentrations showed a dose—dependent absorption of the spray, but none exceeded the potentially toxic level of 5 mg/L.