Search PubMed⌕ Search

Biomedical subjects

H Kaess

Publications and source records attributed to H Kaess.

At least 37 records · Page 2Linked to original sources
PubMed1994

Effect of decaffeination of coffee or tea on gastro-oesophageal reflux.

BACKGROUND: Coffee and tea are believed to cause gastro-oesophageal reflux; however, the effects of these beverages and of their major component, caffeine, have not been quantified. The aim of this study was to evaluate gastro-oesophageal reflux induced by coffee and tea before and after a decaffeination process, and to compare it with water and water-containing caffeine. METHODS: Three-hour ambulatory pH-metry was performed on 16 healthy volunteers, who received 300 ml of (i) regular coffee, decaffeinated coffee or tap water (n = 16), (ii) normal tea, decaffeinated tea, tap water, or coffee adapted to normal tea in caffeine concentration (n = 6), and (iii) caffeine-free and caffeine-containing water (n = 8) together with a standardized breakfast. RESULTS: Regular coffee induced a significant (P < 0.05) gastro-oesophageal reflux compared with tap water and normal tea, which were not different from each other. Decaffeination of coffee significantly (P < 0.05) diminished gastro-oesophageal reflux, whereas decaffeination of tea or addition of caffeine to water had no effect. Coffee adapted to normal tea in caffeine concentration significantly (P < 0.05) increased gastro-oesophageal reflux. CONCLUSIONS: Coffee, in contrast to tea, increases gastro-oesophageal reflux, an effect that is less pronounced after decaffeination. Caffeine does not seem to be responsible for gastro-oesophageal reflux which must be attributed to other components of coffee.

Adult↗
PubMed1994

Effect of the quaternary ammonium compound trospium chloride on 24 hour jejunal motility in healthy subjects.

This study aimed to record 24 hour jejunal motility in healthy ambulant subjects and to analyse changes in motility caused by the oral administration of an anticholinergic agent, the quaternary ammonium compound, trospium chloride. In a placebo-controlled, double blind crossover trial, 24 hour jejunal motility was recorded in 12 healthy volunteers, aged 25 (21-30) years, using a digital data logger connected to two strain-gauge transducers mounted 20 cm apart in a flexible nasojejunal catheter. A computer program was developed to determine contraction parameters. Trospium chloride (15 mg orally thrice daily) prolonged the duration of irregular contractile activity after meals (p < 0.02) and reduced its contraction frequency and amplitude (p < 0.001). In the fasting state, the cycle length of the migrating motor complex was prolonged (p < 0.01) by an extended phase I (p < 0.025). Phase III was shortened (p < 0.005) and showed a slower aboral migration velocity (p < 0.005). Clustered contractions were less frequent during postprandial and fasting periods (p < 0.01). Runs of clustered contractions were completely absent with trospium chloride. Digital manometry was useful for long term recordings of jejunal motility and enabled the motor effects of an anticholinergic agent to be characterised in ambulant subjects.

Adult↗
PubMed1994

Computerized analysis of ambulatory long-term small-bowel manometry.

BACKGROUND: Ambulatory long-term manometry is increasingly being used to study small-bowel motility. This study aimed to develop computer-aided data analysis including the elimination of artefacts, identification of individual phasic contractions, and analysis of aboral propagation. METHODS: Data processing included low-pass filtering, base-line adaptation, cross-comparison of channels, and application of threshold values for contraction parameters. Automated analysis was validated by a visual reference standard. RESULTS: Artefacts were related to cardiovascular and respiratory activity, changes in body posture, and contractions of the abdominal wall. Automated recognition of contractions reached a sensitivity of 92% and a positive predictive value of 88% compared with the visual standard. Mean contraction amplitude and duration of computer analysis were 96% and 93%, respectively, of the visually obtained values. Propagation analysis under ambulatory conditions showed good agreement with previous results by stationary recordings. CONCLUSIONS: Computerized analysis provided valid and reproducible data on small-bowel phasic contractile events and propagative activity by digital long-term manometry.

Adult↗
PubMed1993

Effect of trospium chloride on gastrointestinal motility in humans.

The aim of this double-blind, placebo-controlled, cross-over study was to investigate the effect of trospium chloride on gall bladder contraction, gastric emptying of a liquid meal, gastrooesophageal reflux, and orocaecal transit time in healthy subjects. Gall bladder contraction was examined by ultrasonography before and after stimulation with two raw eggs. Gastric emptying was evaluated by an intubation technique and by sonography. To determine gastrooesophageal reflux and orocaecal transit time, 24-hour pH metry and a hydrogen breath test were used. The gall bladder ejection fractions were significantly lower after oral treatment with both 4 x 10 mg and 4 x 20 mg trospium compared to placebo, but no difference was seen between the two doses of drug. Gastric emptying of a liquid meal was significantly delayed after intake of 4 x 15 mg trospium, whilst the time course of the intragastric volume determined by ultrasound did not differ from that after placebo, suggesting an antisecretory effect of trospium on gastric secretion. The fractional time of oesophageal pH < 4 as a percentage of the entire 24-hour investigation period was significantly increased by treatment with trospium 3 x 15 mg per day. The orocaecal transit time of 10 g lactulose was significantly prolonged. Provided that the observed effects on gall bladder contraction, gastric emptying, and orocaecal transit time are reproduced in disease states, trospium should be regarded as a potentially useful antispasmodic agent.

Adult↗
PubMed1993

Low-proof alcoholic beverages and gastroesophageal reflux.

Previous studies have demonstrated an increased gastroesophageal reflux after the ingestion of high-proof alcoholic beverages in normal subjects. Data on gastroesophageal reflux with usual amounts of low-proof alcoholic beverages are not available. The effect of white wine (7.5% v/v, pH 3.2) and beer (7.0% v/v, pH 4.5) was compared with water, a nonalcoholic beverage of pH 3.2, and an ethanol solution (7.5% v/v, pH 7.6) using ambulatory pH measurement in healthy volunteers. The fraction of time at pH < 4 in the first hour after ingestion of 300 ml white wine (median 13.2%) was significantly increased compared with beer (3.6%; P < 0.01), water (0.9%; P < 0.001), ethanol (1.3%; P < 0.001), and the nonalcoholic beverage (0.9%; P < 0.05). Beer provoked significantly more gastroesophageal reflux than water (P < 0.01). It is concluded that white wine and beer induce gastroesophageal reflux, which is neither related to their ethanol content nor to their pH. The mechanism for this effect remains to be identified.

Adult↗
PubMed1993

Effect of ethanol on absorption of a nutrient solution in the upper human intestine.

The study compares the duodenal and jejunal absorption of an ethanol-containing nutrient solution (4% wt/vol, 4.06 kcal/min = 17.2 kJ/min, 1190 mosmol/kg) with the corresponding ethanol-free solution (2.64 kcal/min = 11.2 kJ/min, 160 mosmol/kg) and with another ethanol-free solution adapted in caloric load and osmolality (4.06 kcal/min = 17.2 kJ/min, 1160 mosmol/kg) by the addition of NaCl and glucose in eight healthy volunteers, using the intestinal perfusion technique. Ethanol added to a nutrient solution did not exert a significant effect on the net absorption of nutrients in the upper intestine. However, duodenal but not jejunal net water (p < 0.05) and sodium (p < 0.02) movements were significantly modified. Compared with the hyperosmolar ethanol-free solution, perfusion of ethanol induced in the duodenum a significantly lower (p < 0.001) net water and sodium secretion and higher absorption rates of total nitrogen and fatty acids (p < 0.001). The importance of the composition of control solutions in studies investigating the effects of ethanol in the gastrointestinal tract is emphasized.

Adult↗
PubMed1992

Effect of ethanol and commonly ingested alcoholic beverages on gastric emptying and gastrointestinal transit.

Acute ingestion of pure ethanol has been reported to delay gastric emptying and to enhance the propulsive movements of the intestine. The aim of the present study was to investigate the comparative effect of beer (7.0% v/v), white wine (7.5% v/v), ethanol (7.5% v/v), and water on the gastric emptying of a liquid test meal and on the gastrocaecal transit time of lactulose added to the test meal. Gastric liquid emptying was assessed by means of a nasogastric intubation technique using polyethylene glycol 4000 as the non-absorbable marker. The gastrocaecal transit time was evaluated by a hydrogen breath test. Beer (P less than 0.001) and white wine (P less than 0.05) significantly accelerated gastric emptying in comparison with ethanol of the same concentration. The gastrocaecal transit time was significantly shorter when the liquid meal was administered with beer compared with ethanol (P less than 0.005) and water (P less than 0.01). The constituents in beer and white wine responsible for our observations remain to be found.

Adult↗
PubMed1992

Absorption of a nutrient solution in chronic alcoholics without nutrient deficiencies and liver cirrhosis.

Duodenal and jejunal absorption of a nutrient solution at two different caloric loads (1.32 and 3.96 kcal/min = 5.6 and 16.8 kJ/min) was compared in chronic alcoholics without malnutrition, liver cirrhosis, obvious small-bowel dysfunction, and exocrine pancreatic insufficiency and in an age-matched control group, by means of the intestinal perfusion technique. In chronic alcoholics duodenal net absorption of water (p < 0.025), sodium (p < 0.02), potassium (p < 0.005), total nitrogen (p < 0.02), carbohydrates (p < 0.05), and lipids (p < 0.05) was lower than in controls when both caloric loads were administered, but jejunal absorption rates were not decreased. Biliopancreatic secretion did not differ between alcoholics and controls. Higher serum protein leakage in alcoholics was indicated by an increased (p < 0.01) duodenal alpha 1-antitrypsin clearance under low caloric load infusion. It is concluded that the absorptive function of the duodenum is impaired in alcoholics, whereas the upper jejunum is not affected.

Adult↗
PubMed1992

Gastric emptying, esophageal 24-hour pH and gastric potential difference measurements in non-ulcer dyspepsia.

Pathological gastroesophageal reflux, prolonged gastric emptying and abnormal gastric potential difference have been claimed to be functional disorders often detectable in non-ulcer dyspspsia (NUD). The role of Helicobacter pylori in NUD is still unclear. The aim of the present study was to evaluate the prevalence of these factors in 47 patients with NUD. According to DeMeester's criteria, 60 percent of NUD patients had abnormal gastroesophageal reflux, while 38 percent had prolonged gastric emptying of a liquid meal. Seventy-nine percent showed abnormal gastric potential difference which was unrelated to Helicobacter pylori colonization, detected in 46 percent of NUD patients. When esophageal pHmetry, gastric emptying evaluation and measurement of gastric potential difference were performed, 89 percent of NUD patients presented at least one abnormal finding.

Adult↗
PubMed1989

Legionella infection of the colon presenting as acute attack of ulcerative colitis.

A 42-yr-old woman with long-standing ulcerative colitis of the descending colon, sigmoid, and rectum presented with bloody diarrhea, tenesmus, and high fever. Endoscopic findings were compatible with an acute attack of ulcerative colitis, which proved to be resistant to systemic corticosteroid treatment. In the presence of an acute abdomen with ascites and double-contoured colonic wall, hemicolectomy was performed. Postoperatively, high temperature, hyponatremia, and elevated liver enzyme levels persisted. Pleural effusions developed. Antibodies to Legionella pneumophila serogroup 3 were detected in the serum. Erythromycin therapy induced rapid improvement. In a massive submucosal edema of the affected colon, L. pneumophila of the same serogroup was demonstrated by direct immunofluorescence staining.

Acute Disease↗
PubMed1989

[Computer-assisted documentation in upper gastrointestinal endoscopy: experiences with routine use at 3 clinics].

The introduction of powerful and inexpensive personal computers (PC) enabled us to develop a documentation system for upper gastrointestinal endoscopy. The system was programmed using the database management system dBASE III. It works on-line, and no computer knowledge or additional staff is needed to run the system. It is now routinely used in the endoscopic units of three different hospitals. Features of performance are a menu-driven data input, automatic report generation and record retrieval, listing according to different criteria as well as other dBASE III facilities. This paper deals with the quality, time effort and user acceptance of the PC-aided system in clinical routine. The analysis showed a good data quality with respect to completeness and adequate use of terminology. Reliability and validity of the documentation were satisfactory considering the methodological problems encountered at their determination. The system was generally judged useful, but time effort was increased compared to conventional documentation.

Documentation↗
PubMed1988

Food intolerance in duodenal ulcer patients, non ulcer dyspeptic patients and healthy subjects. A prospective study.

In 50 duodenal ulcer out-patients and 50 non ulcer dyspeptic patients suffering from low to moderate epigastric painful symptoms the intolerance of 39 foods were significantly increased compared to a group of 50 healthy subjects. Food intolerance was not different between duodenal ulcer and non ulcer dyspeptic patients. Intolerance was related in the majority of nutrients to aversion and pain or to an increased incidence of aversion alone in patients and normals. In duodenal ulcer, coffee and fruit juice were associated with an elevated incidence of pain.

Adolescent↗
PubMed1986

[Therapy of stomach ulcer with sucralfate and ranitidine. A multicenter double-blind study].

134 outpatients with acute benign gastric ulcer confirmed by endoscopic biopsy received either 1 g sucralfate suspension four times daily or one 150 mg ranitidine tablet twice daily for six to 12 weeks in a multicentre therapy study (double-blind study according to the double-dummy technique). After six to 12 weeks, respectively, 56% and 82% of the ulcers had healed in the sucralfate group. The rates of healing in the ranitidine group were 72% and 88%, respectively. The differences in the rates of healing between sucralfate and ranitidine were not statistically significant. Ranitidine was superior to the sucralfate suspension in corpus ulcer. In the distally located ulcers, the two kinds of treatment were equivalent. There were no appreciable differences between the medications with regard to antacid consumption and compliance. Gastric pain was influenced better by ranitidine than by sucralfate.

Antacids↗
PubMed1983

[Mastocytosis simulating a food allergy].

A patient reported that she developed various shock-like symptoms upon intake of alcohol, acetylsalicylic acid, or after injection of contrast medium. After provocation with alcohol applied orally and following endoscopy flush, tachycardia, and a severe headache followed immediately by painful diarrhea were observed. According to our diagnosis the patient had urticaria pigmentosa involving the bone marrow and an enlarged liver and spleen, respectively. The suspected intestinal mastocytosis was confirmed histologically by a biopsy from the jejunum. It was concluded that the symptoms were the result of a direct activation of the accumulated intestinal mast cells. The differential diagnosis of mastocytosis as opposed to allergic gastroenteritis, sprue, and carcinoid is discussed.

Biopsy↗