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Life events and daily stress were assessed in patients with duodenal ulcer, active or in remission, and in matched disease and normal controls. The mean positive life event scores were significantly l

Patients with duodenal ulcers and Helicobacter pylori infection have elevated plasma gastrin concentrations which fall after suppression of the organism. This may be due to

To study the effect of intravenously given omeprazole on the 24-hour gastric secretion, 9 male patients with previously endoscopic proven duodenal ulcer disease were studied. Two four-dose regimens only differing in loading doses were compared. The study showed that 40 mg omeprazole, administered intravenously 4 times a day, is able to keep the gastric pH above 4 in 85% of the 24-hour study period and in 65% of the time pH was above 6. The corresponding values from the baseline period were 10 and 6%. There was no additional effect by a larger loading dose.

Prepyloric (PPU), pyloric (PU), and duodenal bulb ulcers (DU) are traditionally incorporated in the clinical entity ‘duodenal ulcer disease’. Clinical and gastric secretory data were analyzed with res

The efficacy and safety of famotidine (40 mg at night), a new potent H2-receptor antagonist, has been studied in 119 patients by four investigators in four Spanish hospitals in a randomized double-blind comparative study with cimetidine (800 mg at night). Antacid tablets were allowed as additional treatment, if needed for pain relief. There were no significant differences between the groups in baseline characteristics, including duodenal ulcer size. Efficacy parameters included daytime and nocturnal symptom relief and duodenal ulcer healing, documented by endoscopy, and defined as complete reepithelization of the ulcer crater. Endoscopy was performed at baseline and after 4 and 6 weeks of treatment. One hundred and five patients fulfilled the evaluation criteria (51 patients in the famotidine group and 54 in the cimetidine group). After 4 weeks, in 91.6% of the patients receiving famotidine and 82.3% of the patients receiving cimetidine ulcers were healed. After 6 weeks, healing rates were 96% (famotidine) and 85.1% (cimetidine) (p = 0.056). Pain relief was rapid in both treatment groups, with a tendency to better response during the day in the famotidine group. The intake of antacids, as well as the clinical and laboratory safety profile were similar for both groups.

A new model of duodenal ulcer disease has been developed in the mouse. The ulcers were produced after either oral or subcutaneous administration of cysteamine which has been shown to cause duodenal ulcer in the rat. Cysteamine induced duodenal ulcers in a time- and dose-dependent manner after oral administration. The new mouse model shares many similarities with both the rat model and human ulcer disease. Cysteamine caused a significant increase in gastric acidity and pepsin activity. The mouse can be protected against the cysteamine-induced duodenal ulcer by either the dopamine agonist lergotrile or histamine H2 receptor antagonist cimetidine. This new model of duodenal ulcer disease in the mouse may represent a simple and inexpensive way to screen for new antiulcerogenic drugs.

The effects of calcium and secretin were studied in 8 patients with the Zollinger-Ellison syndrome and 18 patients with duodenal ulcer disease. Intravenous infusion of calcium gluconate produced marked increases in serum gastrin levels in the patients with Zollinger-Ellison syndrome (4,350 +/- 1,625 pg/mg) and very slight increases in the patients with duodenal ulcer disease (140 +/- 49 pg/ml). Secretin given as a single intravenous injection also induced marked elevations in serum gastrin in the group with the Zollinger-Ellison syndrome (4,063 +/- 1,990 pg/ml). By contrast, intravenous secretin resulted in a progressive fall in serum gastrin levels in the duodenal ulcer group (from 119 to 97 pg/mg). These results suggest that both stimuli are very useful dagnostic tools in discriminating between Zollinger-Ellison and non-Zollinger-Ellison patients. The secretin challenge test is felt to be superior to the calcium infusions because it is simpler, safer and very rarely produces false-negative or-positive results.

Various investigators have reported that relapses after healing of duodenal ulcers with colloidal bismuth subcitrate (CBS, De-Nol) occur less frequently than after healing with H2-antagonists. To date, treatment with CBS has been limited to 8 weeks. After a volunteer study showed that prolonged administration of CBS did not cause safety problems, a trial was undertaken in which the effects of additional maintenance CBS treatment with 120 mg of CBS daily is compared with placebo. Interim results showed that after 6 months endoscopically confirmed relapse occurred in 5 (38.5%) of the 13 patients as compared to 12 (80%) of the 15 placebo-treated patients (p = 0.05). Besides 3 cases of transient constipation, no side effects, neurological, biochemical or hematological changes were observed.