Dietary fiber and peptic ulcer.
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Animals↗
Biomedical subjects
A Berstad
Publications and source records attributed to A Berstad.
[Smoking and stomach ulcer].
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Duodenal Ulcer↗
[Adverse effects of aluminium-magnesium antacids].
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Aluminum↗
Kinetics of the inhibition of food-stimulated secretion by ranitidine in dogs.
Five Labrador retrievers provided with one vagally innervated and one denervated pouch were given graded doses of food composed of liver, heart and bonemeal to make dose/response curves of food-stimulated gastric secretion. A constant ranitidine infusion resulted in a decreased inhibition of acid output as the physiological stimulation increased both in the innervated and in the denervated pouch. The pepsin output behaved quite differently. The increased physiological stimulation did not increase the pepsin output. There was no inhibition by ranitidine in the innervated pouch and a constant inhibition by ranitidine in the denervated pouch. The results indicated a component of competitive interaction between meal-stimulated acid secretion and the H2-receptor antagonist, which is similar to the interaction between H2-receptor antagonist and histamine.
Animals↗
Prepyloric erosions and related changes.
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Cimetidine↗
Intragastric bile acid concentrations in healthy subjects and in patients with gastric and duodenal ulcer and the influence of fiber-enriched wheat bran in patients with gastric ulcer.
Fasting and postprandial intragastric bile acid concentrations were determined in healthy subjects and in patients with gastric and duodenal ulcer. The results showed great interindividual variation and wide overlapping between groups. Mean bile acid concentrations, fasting and postprandially, were significantly higher in patients with gastric ulcer than in healthy subjects. The differences between gastric and duodenal ulcer patients and between duodenal ulcer patients and healthy subjects were not significant. Fiber-enriched wheat bran reduced bile acid concentrations significantly in patients with gastric ulcer disease.
Adult↗
Duodenal ulcer healing with four antacid tablets daily.
In a double-blind, randomized, multicenter trial in 80 consecutive outpatients with endoscopically verified duodenal ulcer, we have tested the ulcer-healing efficacy of a quite low dose of antacids, given only four times daily. The patients received one chewable aluminum-magnesium-antacid tablet (buffering capacity, 30 mmol/tablet) or placebo 1 h after meals and at bedtime. Re-endoscopy after 4 weeks of treatment showed healed ulcer in 28 of 38 patients (74%) in the antacid group, compared with 11 of 38 patients (29%) in the placebo group (p less than 0.001). The number of days and nights with ulcer pain was significantly less in the antacid group than in the placebo group during the treatment period. Thus, only four antacid tablets a day, with a total buffering capacity of 120 mmol/day, significantly promote duodenal ulcer healing and pain relief.
Adult↗
Fiber diet and antacids in the short-term treatment of duodenal ulcer.
Eighty patients with active duodenal ulcer were randomized to a diet poor or rich in fiber for a treatment period of 4 weeks. In addition, all patients received one antacid tablet (Link, 1.1 g) four times a day (total neutralizing capacity, 120 mmol HCl/day). The ulcer healed in 27 (67.5%) of the 40 patients in the high-fiber group, compared with in 24 (60%) of the 40 patients in the low-fiber group (p less than 0.5). Ulcer symptoms did not differ significantly between groups during the 4-week treatment period. No serious side effects were recorded. Constipation, the most frequently registered side effect, was seen in 11 (27.5%) of the patients in the low-fiber group, compared within 4 (10%) in the high-fiber group (chi-square = 4.0; p less than 0.05). Patients with unhealed ulcer after 4 weeks' treatment received ranitidine instead of antacids. While they were receiving ranitidine treatment, no significant differences in healing rates were seen between the two dietary groups.
Adult↗
Gastric secretion in response to a meal 12-13 h after ranitidine.
In a recent study we demonstrated a marked inhibition of basal gastric acid secretion 12-14 h after oral administration of 150 mg ranitidine. This study investigates the effect of ranitidine on meal-evoked secretion, time interval between drug administration and measurements remaining the same as in a former study. Under the present conditions 150 mg ranitidine had no effect on acid secretion and enhanced pepsin secretion. The results indicate that the effect of the H2-receptor antagonist is surmountable by meal stimulation. The concentrations of ranitidine in basal gastric juice was approximately the same as in blood. The gastric excretion of ranitidine did not increase by meal stimulation and was approximately 0.5% of the excretion in urine.
Adult↗
Mineral-metabolic side effects of low-dose antacids.
Mineral-metabolic side effects of a low dose of a conventional Al-Mg antacid were examined in 10 healthy volunteers, who were given one antacid tablet after the 3 main meals and at bedtime (buffering capacity, 120 mmol/day) for 4 weeks. Compared with the pre-medication state, the following changes of statistical significance occurred during antacid ingestion: increase in urinary excretion of magnesium, calcium, and aluminum; decrease in urinary excretion of phosphate; increase in maximal renal phosphate reabsorption (Tm PO4/GFR); and increase in serum concentration of aluminum. Most of the changes were normalized 3-4 days after cessation of antacid medication. There was no change in intestinal absorption of calcium. The fact that even this low dose of antacids can provoke measurable changes in mineral metabolism, including aluminum absorption, is noteworthy, although we did not see any clinical symptoms from the biochemical changes.
Adult↗
Simulated meal test. A new method for estimation of parietal and non-parietal secretion in response to food.
In ten healthy volunteers gastric secretion was stimulated by a simulated meal, in which the cephalic phase was activated by modified sham feeding and the gastric phase by repeated instillations and withdrawals of a meat soup. The gastric aspirates were analyzed for acid and pepsin and the outputs quantitated by the recovery of an unabsorbable marker (polyethylene glycol). Instillation of liquid meal without sham feeding produced 58% and 65% of pentagastrin-stimulated secretion of acid and pepsin, respectively. Concomitant sham feeding increased the stimulation further, so that the outputs evoked by the combined stimulus (simulated meal test) were similar to that achieved by the pentagastrin test. The coefficient of variation of duplicate tests was 4.5% for acid and 5.4% for pepsin output. The technique is suitable for measuring both parietal and non-parietal secretion in response to food.
Adult↗
Erosive prepyloric changes in persons with and without dyspepsia.
A specified endoscopic picture, consisting of standing prepyloric mucosal folds, injection, and erosions, is denoted erosive prepyloric changes (EPC) and is divided into three grades. In a prospective study in 1001 patients referred for routine upper endoscopy, active EPC (grades 2 and 3) was found in 25.8%, rising to 32.2% in dyspeptic patients with non-ulcer conditions. EPC was significantly more frequent in those below than those above 50 years of age, the male to female ratio being 1.1. In 34.5% of the EPC patients, EPC was an isolated finding. Maximal acid output was, on an average, significantly lower in patients with EPC than in duodenal ulcer patients and similar to that of healthy subjects. Non-ulcer conditions were significantly more frequent, and ulcer in general significantly less frequent, in the EPC group than in a randomly selected control group without EPC. In 34 asymptomatic volunteers the frequency of EPC was 17.6%, significantly lower than in patients of comparable age with non-ulcer conditions. The findings indicate that EPC is related to non-ulcer dyspepsia. The recognition of this condition may lead to a more accurate definition of a patient group with ulcer-like symptoms, without ulcer, and thus, in turn, result in more efficient treatment procedures.
Adolescent↗
Effect of cimetidine in patients with non-ulcer dyspepsia and erosive prepyloric changes.
A double-blind, placebo-controlled trial was performed, using 400-mg cimetidine tablets or placebo twice daily for 4 weeks in 100 patients with non-ulcer dyspepsia (NUD) and erosive prepyloric changes (EPC) grade 2 or 3. Symptomatic assessment was made weekly and endoscopic assessment on completion of the treatment period. Symptomatically, a significant effect of cimetidine versus placebo on epigastric pain/discomfort was recorded after 2 weeks' treatment (p less than 0.05). Endoscopically, there was a significant improvement, according to our grading scale of EPC, in the cimetidine-treated group, as compared to the placebo-treated group (p less than 0.05). On the basis of our findings, patients with NUD and EPC who have epigastric pain/discomfort as a prominent symptom seem to profit from treatment with cimetidine.
Adult↗
The effect of guar gum and fiber-enriched wheat bran on gastric emptying of a semisolid meal in healthy subjects.
The effect of physiological doses of guar gum (Guarem), 5 g, and fiber-enriched wheat bran (Fiberform), 10.5 g, on gastric emptying was studied by two different methods in healthy subjects: by a simple isotope localization monitor placed over the upper part of the abdomen and by gamma camera. The fiber preparations were added to a semisolid meal consisting of wheatmeal porridge and juice, using technetium-99 DTPA as a marker. The gamma camera showed no effect of fiber on gastric emptying. The isotope localization monitor, however, indicated that Fiberform prevented a postprandial accumulation of the meal within the upper part of the stomach. The simple isotope localization monitor cannot be recommended for measurements of gastric emptying.
Adult↗
Dietary aspects of peptic ulcer disease.
Diets modify gastric function in various ways. Fibre influences acidity, pepsin and bile acid concentrations both in vitro and in vivo. Both animal studies and clinical studies in humans give reason to believe that a diet rich in fibre may protect against the development of peptic ulceration.
Animals↗
Opposite effects of H2-receptors on parietal cells and chief cells. Gastric acid and pepsin secretion stimulated by histamine and food combined in dogs: the role of vagal innervation.
The effect of H2-stimulation and blockade was studied in a dog model which made possible physiological stimulation by food and comparison of vagally innervated and denervated acid and pepsin response at the same time. 5 dogs were equipped with two pouches separated from the stomach, and stimulation was done by histamine as continuous infusion combined with a standard meal--a mixture of liver, heart and bonemeal , 10 g/kg. The response was compared with the effect of H2-blockade, cimetidine 5 g/kg, given 30 min before the meal. H2-agonism stimulated acid secretion and strongly inhibited pepsin secretion, and when H2-antagonism was applied, the effects were quite opposite. The results may explain the great differences in acid and pepsin secretion seen after H2-blockade.
Animals↗
Influence of fiber on acidity, pepsin, and bile acids in human gastric juice in vitro.
The effect of a fiber-enriched wheat bran product, Fiberform, and a guar gum, Guarem, on gastric juice acidity, pepsin, and bile acid concentration was studied in vitro. Fiberform had a slight acid-binding capacity. The fiber preparation did not bind pepsin. Both products bound bile acids. With Fiberform the amount of bile acids bound was proportional to the amount of fiber and most pronounced at low pH and high bile acid concentration.
Bile Acids and Salts↗
Influence of fiber on postprandial intragastric juice acidity, pepsin, and bile acids in healthy subjects.
The effect of a fiber-enriched wheat bran product, Fiberform, and a guar gum preparation, Guarem, on postprandial intragastric juice acidity and pepsin and bile acid concentrations was studied in healthy subjects. Fiber-enriched wheat bran prolonged significantly the meal-induced elevation of pH and decrease in pepsin. Both fiber products reduced postprandial intragastric bile acid concentration.
Adult↗