Peptic Ulcer Research Today is a free monthly online journal that collates and summarizes the latest research about Peptic Ulcer, including details on helicobacter pylori, diet, symptoms, treatment.

Neither antioxidants nor COX-2 inhibition protect against esophageal inflammation in an experimental model of severe reflux.

Murphy JO, Ravi N, Byrne PJ, McDonald GS, Reynolds JV

Department of Surgery, St. James's Hospital and Trinity College, Dublin, Ireland.

BACKGROUND: Reflux-induced injury and oxidative stress result in esophageal inflammation and the potential for progression to intestinal metaplasia and adenocarcinoma. Proton-pump inhibitors represent the standard medical approach, but anti-inflammatories and antioxidants offer novel therapeutic possibilities. MATERIALS AND METHODS: Six weeks after an esophagojejunostomy reflux procedure, female Wistar rats (n = 100) were randomized to receive either an antioxidant (vitamin C, 8 mg or 28 mg/day), a cyclooxygenase-2 (COX-2) inhibitor (rofecoxib, 1 mg/day), or no therapy. After sacrifice 16 weeks later, esophageal injury was scored using pathologic and image analysis scoring. RESULTS: Esophagitis was present in all 63 animals completing the study and was severe in 27 (43%). No animal developed metaplasia or tumor. The extent of inflammation and esophageal ulceration were not significantly different between experimental groups. CONCLUSIONS: In this model of reflux injury, antioxidants and COX-2 inhibitors failed to ameliorate the severe inflammation induced. Further experimental designs should evaluate these novel approaches in less severe experimental models.

Published 18 February 2008 in J Surg Res, 145(1): 33-40.
Full-text of this article is available online (may require subscription).

Articles on Peptic Ulcer published 28 January 2008:

Direct evidence of mast cell participation in acute acid-induced esophageal inflammation in mice.   J Pediatr Gastroenterol Nutr, 46(2): 134-8.

OBJECTIVES: Mast cells have been implicated in the pathogenesis of esophagitis resulting from gastroesophageal acid reflux, but their precise role has been difficult to define. We proposed to directly examine the contribution of mast cells to neutrophil infiltration in a mouse model of acid-induced esophageal injury. MATERIALS AND METHODS: Normal and mast cell-deficient (Kit) mice underwent either a surgical procedure to induce acute acid reflux injury of the esophagus or sham surgery. ... [Abstract] [Full-text]

Articles on Peptic Ulcer published 21 January 2008:

Peptic ulcers and erosions are common in Israeli children undergoing upper endoscopy.   Helicobacter, 13(1): 62-8.

BACKGROUND: Peptic ulcers and erosions (PU&E) are thought to be uncommon in children. Patients with early exposure to Helicobacter pylori may be at a higher risk for early onset PU&E. Children in Israel have a high prevalence and early acquisition of Helicobacter pylori (H. pylori) and have easy access to pediatric gastroenterologists and endoscopy. Our aim was to describe the prevalence and characteristics of PU&E in this population referred by Pediatric Gastroenterologists for an ... [Abstract] [Full-text]

Articles on Peptic Ulcer published 16 January 2008:

Hydrogen sulphide-induced hypothermia attenuates stress-related ulceration in rats.   Clin Exp Pharmacol Physiol, 35(2): 223-8.

1. Hydrogen sulphide (H(2)S) acts as a gaseous cellular messenger and has recently been reported to induce a suspended animation-like state in mice. The aim of the present study was to investigate the protective role of H(2)S exposure in stress gastric ulcer. 2. In the present study, we used a rat model of water immersion and restraint stress (WRS) to induce the typical stress disease, namely stress gastric ulcer. Rats were treated with WRS for 4 h, with or without pre-exposure to H(2)S (160 ... [Abstract] [Full-text]

Articles on Peptic Ulcer published 14 January 2008:

Decreasing incidence of symptomatic gastrointestinal ulcers and ulcer complications in patients with rheumatoid arthritis.   Ann Rheum Dis, 67(2): 256-9.

BACKGROUND: Non-steroidal anti-inflammatory drugs (NSAIDs) frequently cause gastrointestinal (GI) ulcers and complications of ulcers. In 1997 in Amsterdam, the incidence of symptomatic GI events was 2.1% (95% CI 1.0-3.1) in patients with rheumatoid arthritis (RA). We conducted a new prospective, observational study on the symptomatic GI events in our outpatient clinics, and compared the data to a previous study conducted by our group. Over the same time period, a decline of GI events over the ... [Abstract] [Full-text]

Articles on Peptic Ulcer published 7 January 2008:

Seeding of the percutaneous endoscopic gastrostomy tract from esophageal squamous cell cancer presenting as an acutely bleeding malignant gastric ulcer: a novel clinicoendoscopic presentation.   South Med J, 101(1): 35-9.

BACKGROUND: While the clinical presentation of cutaneous stomal metastases after percutaneous endoscopic gastrostomy (PEG) placed for pharyngoesophageal malignancy is well described, the clinicoendoscopic findings with gastric stomal metastases is insufficiently characterized. A novel clinicoendoscopic presentation is reported of significant gastrointestinal bleeding caused by an ulcerated gastric stomal metastasis. METHODS: A male patient was admitted for melena with a growing abdominal wall ... [Abstract] [Full-text]

Articles on Peptic Ulcer published 6 December 2007:

Alterations in antral cytokine gene expression in peptic ulcer patients during ulcer healing and after Helicobacter pylori eradication.   Scand J Immunol, 67(1): 57-62.

Earlier studies have shown that the antral immune response in Helicobacter pylori infection has a mixed Th1-Th2-T-regulatory profile. After eradication, a chronic inflammation remains in some patients, but a follow-up study with a comprehensive cytokine profile in has not previously been published. Twelve patients with H. pylori positive peptic ulcer disease (five antral and seven duodenal) were enrolled and cytokine gene expressions in antral biopsies were determined (1) at entry, (2) after ... [Abstract] [Full-text]

Articles on Peptic Ulcer published 30 November 2007:

Hydrogen sulfide enhances ulcer healing in rats.   FASEB J, 21(14): 4070-6.

Hydrogen sulfide is an endogenous mediator that relaxes vascular smooth muscle, exhibits several antiinflammatory activities, and contributes to gastric mucosal defense. This study was performed to examine the role of hydrogen sulfide in the resolution of injury; specifically, the healing of gastric ulcers. Ulcers were induced in rats by serosal application of acetic acid. This elicited a marked increase in gastric expression of the two key enzymes in hydrogen sulfide synthesis ... [Abstract] [Full-text]

Articles on Peptic Ulcer published 8 November 2007:

Oral proton pump inhibitors are as effective as endoscopic treatment for bleeding peptic ulcer: a prospective, randomized, controlled trial.   Dig Dis Sci, 52(12): 3371-6.

In managing patients with bleeding peptic ulcers, it has been reported that pharmacologic treatment can be an alternative to endoscopic treatment. We compared the hemostasis rates of the endoscopic treatment, hemoclipping, and the pharmacologic treatment, oral proton pump inhibitors (PPIs), in bleeding peptic ulcer. A randomized prospective study was performed on 129 bleeding peptic ulcer patients with hematemesis or melena. Sixty-two patients were treated by endoscopic hemoclipping and ... [Abstract] [Full-text]

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