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Biomedical subjects

A Berstad

Publications and source records attributed to A Berstad.

At least 163 records · Page 9Linked to original sources
PubMed1988

Low-dose antacids and pirenzepine in the treatment of patients with non-ulcer dyspepsia and erosive prepyloric changes. A randomized, double-blind, placebo-controlled trial.

One hundred consecutive patients with non-ulcer dyspepsia (NUD) and the endoscopic diagnosis of erosive prepyloric changes (EPC) were included in a 4-week double-blind, placebo-controlled trial. The patients were randomly allocated to treatment with either Al-Mg antacids (one tablet four times daily; acid-neutralizing capacity, 120 mmol/day) or antacid placebo, in combination with either pirenzepine (50 mg twice daily) or pirenzepine placebo. Ninety patients completed the study. Symptoms improved during the 4 weeks in all treatment groups, irrespective of the treatment given. Neither pirenzepine nor antacid was significantly superior to placebo. Re-endoscopy after 4 weeks of treatment showed no significant change in the EPC grade. No serious side effects were observed, but xerostomia occurred more frequently in patients treated with pirenzepine than in those treated with placebo (p less than 0.01).

Adult↗
PubMed1987

Intragastric bile acid concentrations in patients with erosive prepyloric changes.

In the search for pathogenetic mechanisms behind EPC, intragastric bile acids were measured in 60 patients with non-ulcer dyspepsia (NUD) and grade 2 or 3 erosive prepyloric changes (EPC) and in 20 control subjects. Intragastric bile acid concentrations tended to be higher in the control subjects than in the EPC patients, but the difference did not reach statistical significance. The results neither support nor disprove the hypothesis that bile acid-induced mucosal damage may be involved in the pathogenesis of EPC.

Adult↗
PubMed1987

Urinary excretion of aluminium after ingestion of sucralfate and an aluminium-containing antacid in man.

Eleven subjects with normal renal function were given, on 2 separate days, at least 1 week apart, four tablets of sucralfate or an aluminium (Al)-containing antacid. The total Al load was approximately 976 mg with the antacid and approximately 828 mg with sucralfate. The daily urinary excretion of Al was measured the day before and during 3 days after drug administration. Al excretion increased significantly after both drugs. There was no significant difference between the two products. The median absorption calculated as percentage of Al dose was 0.005% (range, 0.001-0.017%) for sucralfate and 0.006% (range, 0.002-0.060%) for the antacid. Thus, measurable quantities of aluminium is absorbed after administration of sucralfate, and the drug should, like Al-containing antacids, be given with caution to patients with renal failure.

Adult↗
PubMed1987

Gastric prostaglandin E2 release induced by aluminium hydroxide and aluminium hydroxide-containing antacids in rats. Effect of low doses and citric acid.

Suspensions of aluminium hydroxide or a commercial antacid containing aluminium hydroxide (Trigastril) was instilled intragastrically in rats in doses comparable to high and low human therapeutic doses (aluminium hydroxide, 125 mg and 12.5 mg/kg, respectively). Corresponding experiments were carried out with 0.6% citric acid added to the antacid suspensions. Prostaglandin E2 (PGE2) in the gastric content was analysed by radioimmunoassay 6 h after drug administration. Both high and low doses of aluminium hydroxide and Trigastril increased the concentration of PGE2 significantly. Citric acid did not significantly affect the antacid-induced PGE2 release except in combination with a low dose of aluminium hydroxide, with which a significant increase was seen. Release of PGE2 by low doses of antacids implies the possibility that enhanced cytoprotection may be involved in the mechanism by which antacids promote the healing of peptic ulcers.

Aluminum Hydroxide↗
PubMed1986

Healing of benign gastric ulcer with low-dose antacids and fiber diet.

A randomized, double-blind, placebo-controlled trial was conducted to determine the efficacy of a low-dose aluminum-magnesium antacid regimen (Link one tablet q.i.d.) (total neutralizing capacity 120 mmol HCl/day) in combination with a high- or a low-fiber diet in ulcer healing and relief of symptoms in patients with benign gastric ulcer. After 6 wk, the ulcer healed in 28 (67%) of the 42 patients treated with antacids compared with 11 (25%) of the 44 patients treated with placebo (p less than 0.001). Antacids were also significantly more effective than placebo in the relief of symptoms. The dietary treatment did not significantly influence ulcer healing or ulcer symptoms. Constipation was more frequently seen with the low- than with the high-fiber diet (p less than 0.01). No significant side effects from antacids were recorded.

Adult↗
PubMed1986

Gastrointestinal absorption of aluminium from single doses of aluminium containing antacids in man.

Ten subjects with normal renal function were given different single doses of aluminium containing antacids (1, 4, or 8 tablets). The antacid tablets (aluminium content 244 mg tablet-1) were chewed and swallowed either with water, with orange juice, or with citric acid solution. There was a marked increase in serum concentration of aluminium when the antacids was ingested with citric acid (P less than 0.001) or with orange juice (P less than 0.05). When antacids were taken with water, a slight, but significant increase in serum aluminium concentration was seen with 4, but not with 1 or with 8 tablets. Following all doses of antacid, a significant increase in 24 h urinary excretion of aluminium was seen. The estimated absorption of aluminium was 8 and 50 times higher when antacids were taken with orange juice or with citric acid, respectively, than when taken with water. Thus, measurable quantities of aluminium are absorbed from single oral doses of antacids. The absorption is substantially enhanced by concomitant ingestion of citric acid.

Administration, Oral↗
PubMed1986

Results of short- and long-term cimetidine treatment in patients with juxtapyloric ulcers, with special reference to gastric acid and pepsin secretion.

One hundred and seven patients with active juxtapyloric ulcers and a history of chronic ulcer disease were treated with cimetidine. After ulcer healing 67 patients were selected for medical management, testing the value of cimetidine maintenance treatment. Time to healing was shorter for patients with duodenal ulcers when compared with those with active prepyloric ulcers. Recurrences were fewer for patients with pure duodenal ulcer disease (DUD) when compared with those with active or previous prepyloric ulcer disease (PUD). Patients whose ulcers were slow to heal and those with active or previous prepyloric ulcers (PUD) required a higher dose of cimetidine for effective control of their disease. All patients with slowly healing ulcers (more than 6 weeks) relapsed with 400 mg cimetidine at night. Among patients with relapse 46% with DUD and 31% with PUD were controlled by increasing cimetidine to 400 mg twice daily. Tests of acid secretion were of no value in predicting the rate of ulcer healing or relapse rate. Pepsin secretion studies, however, were of predictive value for patients with DUD but of indeterminate value for patients with PUD. Long-term cimetidine produced a significant decrease in pentagastrin-stimulated pepsin secretion (without treatment) in both patients with and without relapse. No significant changes in acid secretion were observed. As a result of these studies we recommend a cimetidine maintenance dosage of 400 mg twice a day for all patients whose ulcers are slow to heal on 1 g cimetidine a day and in patients with prepyloric ulcer disease regardless of rate of healing.

Cimetidine↗
PubMed1986

Relationship of hiatus hernia to reflux oesophagitis. A prospective study of coincidence, using endoscopy.

A prospective study of the incidence of hiatus hernia and/or reflux oesophagitis was carried out in 670 patients referred for routine upper alimentary endoscopy. Hiatus hernia was found in 16.6% and reflux oesophagitis in 15.1% of the patients. Forty-two per cent of the patients with hernia did not have oesophagitis, whereas 63% of the patients with reflux oesophagitis had hernia. In patients without reflux oesophagitis the incidence of hiatus hernia was 8%. Reflux oesophagitis was significantly (p less than 0.001) related to hiatus hernia. The severity of the oesophagitis was significantly (p less than 0.05) related to the presence and the size of hernia, and severe oesophagitis without hernia was significantly (p less than 0.01) related to chronic alcoholism. The results suggest that a sliding hiatus hernia may play a role in the development of reflux oesophagitis.

Alcoholism↗
PubMed1986

Augmented postprandial gastric acid secretion due to exposure to ranitidine in healthy subjects.

In 10 healthy volunteers gastric acid output in response to a meal was significantly increased 60-64 h after cessation of 4 weeks of ranitidine treatment as compared with the response before treatment. Four to 6 weeks after discontinuation of treatment the acid secretory response to the meal had returned to values not significantly different from those seen before treatment. There was no change in pepsin output owing to ranitidine treatment.

Adult↗
PubMed1986

Effect of ranitidine on meal-induced gastric pepsin and acid secretion and the influence of adding ethanol to the meal.

The effect of ranitidine on meal-stimulated pepsin and acid secretion 3-4 h after administration of the drug was compared in 10 healthy volunteers. The results showed an insignificant reduction of pepsin output, whereas acid output was reduced 78.5%, demonstrating the difference in response of the chief and parietal cells to an H2-receptor antagonist. Adding ethanol to the meal did not reduce the acid-inhibiting effect of ranitidine.

Adult↗
PubMed1986

Histological findings in erosive prepyloric changes.

To study the histology of erosive prepyloric changes (EPC), 5 bioptic specimens per examination were obtained from the prepyloric mucosa during 161 upper endoscopies in persons with and without EPC. The macroscopic erosions of EPC grade 3 were histologically verified in 88% of the cases. Histologically diagnosed erosions were always accompanied by an element of acute inflammation. The incidence of acute inflammation increased with increasing grades of EPC, from 5% in grade 0 and 1, through 26% in grade 2, to 96% in grade 3. The incidence of chronic inflammation was 0 in grade 0, 50% in grade 1, 46% in grade 2, and 90% in grade 3. On the whole, gastritis was found in 98% of the cases with EPC grade 3, as compared with approximately 50% in grades 2 and 1. Fibrosis was diagnosed in all the cases. The mean thickness of the foveolar layer increased with increasing grades of EPC, the values being significantly higher in grades 2 and 3 than in grade 0, with, however, considerable overlapping between groups. Cimetidine was found to have no effect on the histological features of chronic/acute inflammation and erosion.

Biopsy↗
PubMed1986

Antacids for peptic ulcer: do we have anything better?

During recent years several reports have appeared documenting that antacids containing aluminium hydroxide accelerate the healing process of duodenal ulcer. In gastric ulcer, however, only one study has demonstrated an effect clearly superior to that of placebo. Several studies, in both gastric and duodenal ulcer patients, have not been able to demonstrate any significant difference between antacids and H2 blockers with respect to ulcer healing and symptom relief. An important acknowledgement is the fact that the doses of antacids required for ulcer healing are much smaller than first assumed, and that tablet formulations of antacids are at least as effective as liquid antacid suspensions. The excellent effect of the more convenient low-dose tablet regimens has strengthened the position of antacids in the competition with other anti-ulcer drugs. Usually, side effects of low-dose antacid regimens are few and mild. In patients with impaired renal function, accumulation of absorbed aluminium may have serious consequences. However, in patients with healthy kidneys, aluminium is quickly excreted after absorption, and unhealthy effects are not documented. Antacids should therefore still constitute a cornerstone in the treatment of peptic ulcers.

Adult↗