Peptic ulcer disease antacids

Localised upper abdominal pain is the most common symptom of peptic ulcer disease. The pain is relieved by antacids, proton pump inhibitors and H2 antagonists. The pain may or may not be relieved by food and is often v/orse during the night. Peptic ulceration may be accompanied by occasional vomiting, anorexia and weight loss. Diffuse abdominal pain is not a characteristic symptom of peptic ulcer disease. 

A 39-year-old woman who took high doses of aluminium and magnesium hydroxide for peptic ulcer disease (over 18 kg of elemental aluminium and 15 kg of elemental magnesium over 8 years) developed severe osteomalacia due to profound phosphate depletion (60). Bone biopsy showed stainable aluminium deposits along 28% of the total bone surface, a unique observation in a patient with normal renal function. Treatment included withdrawal of the antacid and supplementation with phosphate, calcium, and vitamin D. Her bone mineral density increased over the next 2 years. 

Drugs have also been associated with osteomalacia. Anticonvulsants increase the hepatic cataboHsm of vitamin D metabolites, and produce end-organ resistance. Phosphatebinding antacids used for treatment of peptic ulcer disease cause osteomalacia by preventing the intestinal absorption of phosphate. Etidronate treatment (e.g., of Paget s disease, osteoporosis, or hypercalcemia of mafignancy) can cause a mineralization defect and result in osteomalacia. 

Peptic Ulcer disease High-dose antacids 19 6 (35%)... 

Metabolic alkalosis may also be generated by the gain of exogenous alkali. This may be seen as a result of bicarbonate administration or from the infusion of organic anions that are metabolized to bicarbonate, such as acetate, lactate, and citrate. The milk-alkali syndrome was historically a common cause of metabolic alkalosis in patients with peptic ulcer disease secondary to the ingestion of large quantities of milk products and antacids. This syndrome has become increasingly uncommon with the advent of alternative effective therapies for dyspeptic syndromes. 

This macrolide can be used effectively for the treatment of nongonococcal genital infections [331, 332]. In the therapy of H. py/on-associated peptic ulcer disease, combination therapy of spiramycin, metronidazole, and antacid/bismuth resulted in ulcer healing rates of 89-91% and bacteriological eradication rates of... 

Antacids are similar to blockers in efficacy in treating peptic ulcer disease, but require higher doses and more frequent administration and are less palatable (Table 6.1). Antacids are used alone or in combination with blockers for GERD, primarily to relieve epigastric pain and heart burn. Antacids differ dra-maticcdly with respect to buffering capacity and cost. 

Administer with an antacid to prevent peptic ulcer disease. 

The evolving trend to use less invasive methodology in the management of peptic ulcer disease resulted in a significant interest in the use of antacids in association with both diet modification and bed rest. 

In humans, antacids are used primarily to control symptoms of dyspepsia (heartburn, upset stomach) and these agents are not considered primary therapy for the treatment of ulcer disease. Only subjective assessments are available for evaluating the effects of antacids on signs of gastric discomfort in horses and the author has noted a substantial disparity between the effectiveness of antacids reported by owners and trainers and endoscopic findings. The latter observations at least indicate ineffectiveness of antacids in treating peptic lesions in horses. 

Diuretics, by increasing kidney output, deplete calcium, magnesium, potassium, and zinc. This, in turn, depletes energy and lowers immune function. Over-the-counter antacids, as well as the peptic ulcer medication cimetidine, reduce iron and calcium assimilation, vitamin Bj , and intrinsic factor (without which Bi2 can t be absorbed). Drugs prescribed for heart disease reduce libido, and some of them render men impotent. 

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