Duodenal ulcer disease

Davies, G.K, Simmonds, N.J., Stevens, T.R.J., Grandison, A., Revell, P., Blake, D.R. and Rampton, D.S. (1992a). Mucosal reactive oxygen metabolite production in duodenal ulcer disease. Gut 33, 1467-1472. 

Pennickx, F., Vuysteke, P. and Kerremans, R., Recurrences after highly selective vagotomy in refractory and non-refractory duodenal ulcer disease. Acta Chirurgica Belgica 90, 41-45, 1990. 

Given the role of H. pylori infection in gastric cancer and duodenal ulcer disease, one must note that certain interleukin-1 gene cluster polymorphisms (suspected of increasing production of interleukin-1-/1) are associated with a predisposition to hypochlorhydria and gastric cancer [52]. One of these host DNA polymorphisms involves a TATA box. 

Dopamine Agonists and Antagonists in Duodenal Ulcer Disease... 

Thus, certain dopamine agonists especially dopaminergic aporphine alkaloids may represent new agents to prevent or treat duodenal ulcer disease. 

The neurotransmitter dopamine has currently found clinical application in the treatment of cardiovascular collapse and shock. Treatment with dopamine-related drugs has been limited to such brain disorders as Parkinson s disease, schizophrenia, and hyperprolactinemias. Accumulating data from animal experiments, however, indicate the possible involvement of dopamine in other diseases and the potential use of dopamine agonists or antagonists in these disorders. Gastrointestinal disturbances (especially duodenal ulcer disease) seem to represent such a group of dopamine-sensitive alterations. 

Circunstantial evidence directly implicating dopamine in the pathogenesis of duodenal ulcer in man is the unusual incidence of peptic ulcer disease in dopamine-deficient disorders. From purely descriptive clinical and epidemiologic studies we know that patients with Parkinson s disease, before the introduction of dopamine therapy, had an excess of ulcer disease (72). One report even comments on the curiosity that after initiation of L-DOPA administration the ulcer symptoms have virtually disappeared (72 ). On the other hand, less clearly, schizophrenia which is associated with dopamine excess and/or receptor hyperactivity is accompanied by virtual lack, or decreased prevalence, of peptic ulcer (73-76). Schizophrenia associated with ulcer disease has been viewed as a reportable curiosity in medical literature (75). At present, possibly because of the widespread therapeutic application of neuroleptics, the lack of peptic ulcer disease in schizophrenics is less striking than in the past. On the other hand, we recently observed in our autopsy series perforated duodenal ulcers in two schizophrenic patients who had been on large doses of haloperidol therapy (Szabo, unpublished observation). Thus, even in man, dopamine may indeed be implicated in the pathogenesis of duodenal ulcer disease. 

R. McGloy, G. Greenberg, and J. Baron. Duodenal pH in health and duodenal ulcer disease effect of a meal, Coca-Cola, smoking and timetidine. Gwt 25 386... 

Duodenal ulcer disease 20 mg p.o. q.d. after the morning meal for up to 4 weeks... 

A5. Anderson, R. K., Fogelson, S. J., and Farmer, C. J., Gastric mucus secretion in gastro-duodenal ulcerative disease. Proc. Soc. Exptl. Biol. Med. 31, 520-522 (1933-34). 

Laine L, Suchower L, Frantz J, Connors A, NeU G. Twice-daily, 10-day triple therapy with omeprazole, amoxicillin, and clarithromycin for Helicobacter pylori eradication in duodenal ulcer disease results of three multicenter, double-blind, United States trials. Am J Gastroenterol 1998 93(11) 2106-12. 

Cimetidine is indicated for the treatment of disorders associated with hypersecretion of gastric acid, for example, gastric and duodenal ulcer disease, gastroesophageal reflux. The drug competitively antagonizes the H-2 receptor of the parietal cells. 

At least 95% of patients with duodenal ulcer disease are infected with H. pylori, and eradication of the organism leads to healing of the ulcer and reduction in relapse rates. Eradication of H. pylori is now the recommended treatment for patients with duodenal or gastric ulcer who are H. pylori-positive. Effective combined antibiotic and add suppression regimens (using PPIs) are available with eradication rates of about 90% after first-line treatiment. ... 

Figure 48-5 Basal add output in healthy volunteers and patients with duodenal ulcers (DUs) of varying H pylori status ( , H pylori positive). Compared with H. pylori-negative healthy volunteers, basal acid output is increased in H py/or/-positive healthy volunteers P < 0.05), H py/orf-positive patients with DUs (P< 0.0001), and patients with DUs I month after eradication (P<0.0l). (From El-Omar EM, Penman ID,Ardill JES, Chittajallu RS, Howie C, McCoIl KEL H. pylori infection and abnormalities of acid secretion in patients with duodenal ulcer disease. Gastroenterology 1995 109 681 91, with permission from the American Gastroenterological Association.)...

El-Omar EM, Penman ID, Ardill JES, Chittajallu RS, Howie C, McCoU KEL. Helicobacter pylori infection and abnormalities of acid secretion in patients with duodenal ulcer disease. Gastroenterology 1995 109 681-91. 

Shiotani A, Graham D, Pathogenesis and therapy of gastric and duodenal ulcer disease. Med Clin N Am 2002 86 1447-66. 

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