Lipid peroxidation in the blood and tissues of patients with peptic ulcer]

Investigation of 67 patients with peptic ulcer revealed a reliable activation of lipid peroxidation processes both in the blood of the patients and in the mucous membrane in the area of the ulcer location immediately. The activation of lipid peroxidation resulted in a decrease in the contents of phospholipids in the biological membranes of the mucosa cells. The alterations revealed occurred in the presence of inhibition of the antioxidant system of the body. The authors proved the efficacy of the use of antioxidant formulations and ultraviolet irradiation of the blood in the treatment of patients which resulted in acceleration of the ulcer cicatrization and the reduction of the inpatient period as well as the improvement of surgical results.     

Medical treatment of peptic ulcer disease.

Our understanding of PUD and its treatment has improved dramatically during the past 15 years. During this time, many new effective drugs have been approved by the FDA, and possibly even more potent and effective therapies are now being evaluated. The H2-blockers, sucralfate, and antacids heal over 90% of duodenal ulcers in 6 to 8 weeks, and H2-blockers heal about 80% of gastric ulcers by 8 weeks and over 90% by 12 weeks. The new, more potent pump blockers (omeprazole) promise to be even more effective drugs, even for the healing of patients who are taking NSAIDS. However, the potential hazards of marked, long-term acid suppression must still be evaluated. Maintenance therapy with H2-blockers or sucralfate, ideally used for patients who would otherwise have frequent symptomatic recurrences of duodenal ulcer disease or who have had complications, reduces the relapses, especially symptomatic relapses. Maintenance therapy with H2-blockers also seems to reduce the recurrences of GUD, but this use has not yet received FDA approval. Elimination of H. pylori infection with antibiotics may prove to reduce recurrent ulcer disease and negate the need for maintenance therapy. Colloidal bismuth subcitrate alone, which suppresses but does not eradicate H. pylori infection, seems to be an effective ulcer drug and may even reduce the rate of early recurrences. Effective ulcer therapy, especially if it prevents recurrent disease, may reduce the complications of PUD, but this expectation has yet to be established. The use of prophylactic cytoprotective prostaglandins (misoprostol) reduces the incidence of NSAID-induced GUD.     

Ranitidine in the treatment of peptic ulcer

A randomized, double-blind study was done to determine the efficacy and safety of ranitidine in the short-term treatment of duodenal and benign gastric ulcers. Fifty-one patients with duodenal ulcer and 44 patients with gastric ulcer were admitted to the study. Forty-two duodenal ulcer patients and 36 gastric ulcer patients completed the study. In the duodenal ulcer group, 14 (70%) of 20 patients on ranitidine and one (4.5%) of 22 patients on placebo were healed. In the gastric ulcer group, 12 (75%) of 16 patients on ranitidine and six (30%) of 20 patients on placebo were healed. The healing percentages in both groups significantly favored ranitidine. Ranitidine was also significantly better than placebo in relieving ulcer pain. No side effect could be attributed definitely to ranitidine.     

Epidemiology of peptic ulcer in the elderly

The frequency of severe complications is higher in elderly patients than in young patients. NSAIDs and low-dose aspirin are often prescribed for elderly patients. Physiological functions of the stomach such as acid secretion in elderly patients are also different from those in young patients. Hemorrhage and perforation can suddenly occur in elderly patients even though abdominal symptoms are mild. There is a tendency for the condition of such patients to deteriorate and long-term hospitalization is often required. Effective prevention measures are necessary since it is expected that cases of gastrointestinal injury caused by NSAIDs will continue to increase.