- Mucosal permeability and mast cells as targets for functional gastrointestinal disorders. [Review]
- COCurr Opin Pharmacol 2018 Sep 11; 43:66-71
- The intestinal mucosa is constantly exposed to harmful luminal content, and uptake is closely controlled and regulated by neuro-immune factors. If control is broken, it might lead to ongoing enhanced...
The intestinal mucosa is constantly exposed to harmful luminal content, and uptake is closely controlled and regulated by neuro-immune factors. If control is broken, it might lead to ongoing enhanced mucosal permeability, potentially resulting in functional gastrointestinal disorders. The importance of mast cells in the regulation of the mucosal barrier has become obvious, and increased numbers and more activated mast cells have been observed in irritable bowel syndrome, functional dyspepsia and gastroesophageal reflux disease. To target the disturbed mucosal permeability, directly or via mast cells, is therefore currently of major interest. For example, administration of mast cell stabilizers and probiotics have shown promising effects in patients with functional gastrointestinal disorders.
- Helicobacter pylori and nonmalignant upper gastrointestinal diseases. [Review]
- HHelicobacter 2018; 23 Suppl 1:e12522
- The review of the most important recent publications concerning the relation of Helicobacter pylori with peptic ulcer disease (PUD), noninvestigated and functional dyspepsia, and gastroesophageal ref...
The review of the most important recent publications concerning the relation of Helicobacter pylori with peptic ulcer disease (PUD), noninvestigated and functional dyspepsia, and gastroesophageal reflux disease (GERD) is presented. H. pylori remains the main etiopathogenetic factor in complicated and uncomplicated PUD. Nevertheless, the role of nonsteroidal anti-inflammatory drugs (NSAIDs) and aspirin is increasing. The novel data did not confirm that PUD caused by NSAIDs and aspirin is less symptomatic. The role of glucocorticoids, immunosuppressants, and antidepressants seems to be of some importance. Although the involvement of H. pylori in functional dyspepsia is controversial, several data support the importance of H. pylori-induced gastritis in the pathogenesis of dyspeptic symptoms. Recent interventional studies have reported that H. pylori eradication improves dyspepsia mainly in areas with a high prevalence of this bacterium. Novel data regarding the relation of gastrointestinal peptides, ghrelin and obestatin, with H. pylori infection are also presented. Intriguing findings support the involvement of the gastric microbiota in the causation of chronic functional dyspepsia. Finally, some data concerning negative, positive, or neutral associations of H. pylori with gastroesophageal reflux disease (GERD) were published. In this context, today there is no evidence indicating that H. pylori eradication could worsen the symptoms or the course of GERD.
- Inappropriate Prescription of Proton Pump Inhibitors in a Community Setting. [Journal Article]
- CJCan J Hosp Pharm 2018 Jul-Aug; 71(4):267-271
- CONCLUSIONS: These findings suggest that inappropriate prescribing of PPIs remains problematic in the community setting in the province of Quebec.
- Sleep Disturbance and Its Association with Gastrointestinal Symptoms/Diseases and Psychological Comorbidity. [Journal Article]
- DDigestion 2018 Sep 04; :1-8
- CONCLUSIONS: Future studies will be needed to clarify the interrelationships among SD, psychological stress, and functional gastrointestinal disorders.
- Sleep Disturbances Are Commonly Reported Among Patients Presenting to a Gastroenterology Clinic. [Journal Article]
- DDDig Dis Sci 2018 Aug 09
- CONCLUSIONS: Patients presenting to a tertiary care GI clinic report poorer sleep than healthy controls. In general, patients with IBS report the highest rates of sleep difficulties compared to patients with other diagnoses.
- Prevalence and the risk factors of gastro-esophageal reflux disease in medical students. [Journal Article]
- MJMed J Armed Forces India 2018; 74(3):250-254
- CONCLUSIONS: Prevalence of symptoms of GERD in medical students is 25%, majority had mild symptoms. Associated dyspeptic symptoms were present in 38.6%. Factors predisposing to GERD in them are higher BMI, final years of MBBS course, use of NSAID, inadequate sleep, sleeping within one hour of taking dinner, missing breakfast on regular basis and quick eating.
- Long-term outcomes of patients with symptomatic gastroesophageal reflux disease treated with vonoprazan. [Journal Article]
- SJScand J Gastroenterol 2018 Jul 28; :1-8
- CONCLUSIONS: One-year treatment with vonoprazan significantly improves GERD symptoms and endoscopic healing of erosive esophagitis is satisfactory. The long-term use of vonoprazan is effective and useful to control GERD.
- Rationale use of proton pump inhibitors: Observational study of hospital based prescriptions and role of clinical pharmacist. [Journal Article]
- PJPak J Pharm Sci 2018; 31(4):1217-1227
- The rationale of acid suppressant therapy with PPIs was assessed to measure the treatments conformity in PGHI under clinical guidelines. The irrational use of PPIs was found to induce side effects in...
The rationale of acid suppressant therapy with PPIs was assessed to measure the treatments conformity in PGHI under clinical guidelines. The irrational use of PPIs was found to induce side effects in patients and increased budgetary constraint. In a 4 phase study, 2 groups of patients (784 and 2804) were selected; Pre intervention retrospective review of the prescriptions was done in phase I. Insightful awareness in clinicians and patients was created in phase II a and II b respectively. The ongoing prescriptions were intervened in phase III. The post-intervention retrospective audit of prescription was completed in phase IV. The data was recorded for chronic disease patients in the hospital, revealed a marked reduction (85%) in the frequency of PPI's prescriptions (784 to 117), Cost of PPI's /year reduced to 19.3% , from US$: 24522/- to US$: 4718/-. The side effects reported in patients' feedback was also reduced such as hypocalcaemia (59%), hypomagnesaemia (52%), anemia (28%), reflux dyspepsia (82%), C. difficile associated diarrhea (15%), pneumonia (5%), and nephritis in patients with CKD (11%). The intervention induced awareness in Clincians (85%), in patients (38%), reduction in PPIs prescription (45%), whereas cost of PPI's prescription in group 2 was reduced from US$ 36481/- to US$:10325/- i.e. (28%).
- Gastric mucosal prolapse: A case of proton-pump inhibitor nonresponsive dyspepsia. [Journal Article]
- CCClin Case Rep 2018; 6(7):1377-1378
- Gastric mucosal prolapse (GMP) is a rare clinical syndrome that in patients with hiatal hernias and gastroesophageal reflux disease (GERD) may present with typical findings of abdominal pain and refl...
Gastric mucosal prolapse (GMP) is a rare clinical syndrome that in patients with hiatal hernias and gastroesophageal reflux disease (GERD) may present with typical findings of abdominal pain and reflux symptoms but prove resistant to medical therapy. Physicians should therefore be aware and consider GMP as a differential in such patients in order to make an accurate diagnosis and provide timely treatment.
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- The Role of Proton Pump Inhibitors in the Management of Upper Gastrointestinal Disorders. [Journal Article]
- GHGastroenterol Hepatol (N Y) 2018; 14(3):169-175
- Proton pump inhibitors (PPIs) have been in use since the early 1990s and play a crucial role in the management of a number of conditions affecting the upper gastrointestinal tract, including gastroes...
Proton pump inhibitors (PPIs) have been in use since the early 1990s and play a crucial role in the management of a number of conditions affecting the upper gastrointestinal tract, including gastroesophageal reflux disease, Barrett esophagus, eosinophilic esophagitis, and dyspepsia. PPIs also play an important role in the treatment of Helicobacter pylori infection and in the prevention of upper gastrointestinal tract ulcers and bleeding among patients taking antiplatelet therapy and/or nonsteroidal anti-inflammatory drugs. Despite recent concerns regarding the long-term safety of PPIs, their risk-benefit profiles strongly favor their appropriate use in patients who have genuine indications for them. As with all drugs, PPIs should be administered in the lowest effective dose and only for as long as clinically indicated. However, for at least some of their approved indications, PPIs are likely to be required indefinitely. This article outlines the current indications for PPIs for the management of upper gastrointestinal disorders and reviews safety concerns.