Effects of oral magnesium sulphate on colonic motility.
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Biomedical subjects
Publications and source records attributed to A E Read.
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A high-dose double-blind trial of carbenoxolone sodium capsules (Duogastrone) in the treatment of duodenal ulceration was combined with endoscopic diagnosis and follow-up. Thirty-one ambulant patients with an endoscopically visible duodenal ulcer were allocated at random to a 12-week course of treatment with either carbenoxolone sodium 300 mg daily or a placebo. Symptomatic and endoscopic follow-up was performed at 2-4 weeks, 6-8 weeks, and 12-16 weeks. Carbenoxolone was shown to increase the rate of healing of duodenal ulcers in the early stages of treatment, but by 12 weeks there was no difference between the two groups. There was no significant difference in symptomatic improvement between the two groups at any stage of treatment. Side effects, especially hypokalaemia, were prominent in the patients treated with carbenoxolone. There was a poor relation between endoscopic and symptomatic improvement in patients on either form of treatment.
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Needle liver biopsies of patients with idiopathic recurrent cholestasis were studied by light and electron microscopy. Many hepatocytes showed non-specific damage to their organelles. Crystalloids were found both in the cytoplasm and within mitochondria in one patient. The microscopic and clinical findings were interpreted as being in favour of primary hepatocyte injury.
Two-hundred fibreoptic examinations of the duodenal bulb were carried out on 149 patients. The importance of combining the initial examination with a general endoscopic survey of the oesophagus and stomach is stressed. At the present time full examination of the duodenal bulb requires the use of both a side-viewing and forward-viewing endoscope in more than a quarter of cases. The safety and acceptability to the patient of multiple endoscopic examinations carried out as an outpatient procedure has been demonstrated, and the value of the procedure in x-ray negative dyspepsia, in the follow up of ulcer therapy, and in acute upper gastrointestinal haemorrhage has been shown.
Patients with cirrhosis were found to be extremely sensitive to tranylcypromine, and the use of this drug for the treatment of depression in such patients is contraindicated. Amitriptyline has a wider margin of safety in such patients, but caution is necessary when the higher therapeutic doses are prescribed.
Estimations of the concentration of secretory IgA have been performed on 152 specimens of saliva from 46 patients with adult coeliac disease. The results are compared with values observed in 20 normal subjects. The mean salivary IgA concentration was 9 mg% in 36 patients on a normal diet and 7.9 mg% in 21 patients on a gluten-free diet. In 20 normals the mean salivary IgA was 7.1 mg%. Nine patients were studied before and after gluten exclusion. Seven of these showed a marked fall in salivary IgA concentration after gluten was excluded.
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