Disease Management in Ulcer Disease

Boer, E. A. M. Joosen W. A. de

doi:10.1080/003655299750025507

Cited by 6 publications

(1 citation statement)

References 22 publications

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“…Hence, it is not suprising that the present systematic determination of hCT in more than 150 patients with hyperthyroidism failed to identify any patients with hypercalcitonemia. Endogenous gastrin may [11]or may not [12, 13]be a stimulus for the secretion of calcitonin. At least in patients with hyperthyroidism, hypergastrinemia appears to be of no consequence for calcitonin secretion, since calcitonin was normal in all hyperthyroid patients with elevated serum gastrin; conversely, gastrin was normal in all hypercalcitonemic, hyperthyroid patients.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Hypergastrinemia in Patients with Hyper- and Hypothyroidism: Impact for Calcitonin?

Vierhapper¹,

Nowotny²,

Bieglmayer

et al. 2002

Horm Res Paediatr

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Objectives: To evaluate the prevalence of hypergastrinemia in patients with hyperthyroidism and hypothyroidism and to determine whether gastrin-induced hypercalcitonemia could explain the high prevalence of thyroid C-cell hyperplasia among patients with hyperthyroidism. Methods: Concentrations of gastrin and of hCT were determined by commercially available radioimmunoassays. Results: Elevated serum concentrations of gastrin were found in 17 of 161 (10.5%) patients with manifest hyperthyroidism (Graves’ disease) and in 4 of 37 (10.8%) and 23 of 255 (9.0%) patients with manifest or subclinical hypothyroidism, respectively. Only 2 cases of hypergastrinemia of 255 subclinically hypothyroid patients (0.8%) could not be linked to thyroid autoimmune disease by either biochemical or sonographic criteria. Four patients with Graves’ disease presented elevated plasma concentrations of calcitonin, but none of these patients also had an elevated serum gastrin. Conclusions: The prevalence of hypergastrinemia in autoimmune thyroid disease is about 10%. The determination of gastrin in subclinical hypothyroidism is not cost-effective in the absence of biochemical and/or sonographic markers of autoimmune thyroid disease. The determination of gastrin is of no use to predict the presence of C-cell hyperplasia commonly seen in patients with Graves’ disease.

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Section: Discussionmentioning

confidence: 99%

Prevalence of Hypergastrinemia in Patients with Hyper- and Hypothyroidism: Impact for Calcitonin?

Vierhapper¹,

Nowotny²,

Bieglmayer

et al. 2002

Horm Res Paediatr

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Controversies in dyspepsia

Berstad¹,

Ólafsson²,

Tefera³

et al. 2001

Eur J Surg

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Even in the absence of visible lesions like an ulcer, cancer or oesophagitis, patients with functional dyspepsia may complain of severe dyspeptic symptoms and have a poor quality of life. Characteristically, these patients also often have a low estimate of their own health and have complaints from several organ systems. The cause of the disease is not known. Both central nervous system and gastric disturbances appear to be involved, and their relative importance is controversial. There is no clear beneficial effect of acid suppression or H. pylori eradication although effects of such therapy may be seen in minor subgroups. New findings emphasise the importance of distinguishing between functional dyspepsia and gastro‐oesophageal reflux disease, which exhibit completely different gastric accommodation patterns to a meal and have very different therapeutic potential. The effect of drugs like glyceryl trinitrate, glucagon, sumatriptan and buspirone which all concomitantly improve symptoms and gastric accommodation support the important role of abnormal gastric accommodation to meals in patients with functional dyspepsia. A hypothetical model for the pathogenesis of functional dyspepsia is presented. It incorporates four established abnormalities: various psychological abnormalities, low vagal tone, impaired gastric relaxation, and visceral hypersensitivity, in a logical interplay along the brain‐gut axis. Copyright © 2001 Taylor and Francis Ltd.

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Should anti-Helicobacter therapy be different in patients with dyspepsia compared with patients with peptic ulcer diathesis?

Boer

Tytgat²

2001

European Journal of Gastroenterology & Hepatology

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Physicians should try to reach an optimal cure rate with initial anti-Helicobacter therapy. Helicobacter pylori infection in patients with peptic ulcer disease (PUD) is more likely to be cured then in patients with 'functional' dyspepsia (FD). Differences in cure rates of 5-15% are usually reported, which is considered to be clinically relevant. Different strains (virulent v. non-virulent) in PUD and FD may induce different alterations in the gastric mucosa, and thereby either facilitate or impair antimicrobial efficacy. A study in this journal showed that triple therapy with ranitidine bismuth citrate (RBC) was superior to triple therapy with a proton pump inhibitor (PPI), but only in the more-difficult-to-cure FD patients. Clinicians should be aware that most published treatment studies have included only PUD patients. This means that in clinical practice the cure rates obtained in patients with FD or even uninvestigated dyspepsia will usually be lower then those reported in the literature. One way to deal with this is to consider prolonging the duration of an initial anti-Helicobacter therapy from 7 to 10 or 14 days in patients without ulcers.

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Disease Management in Ulcer Disease

Cited by 6 publications

References 22 publications

Prevalence of Hypergastrinemia in Patients with Hyper- and Hypothyroidism: Impact for Calcitonin?

Prevalence of Hypergastrinemia in Patients with Hyper- and Hypothyroidism: Impact for Calcitonin?

Controversies in dyspepsia

Should anti-Helicobacter therapy be different in patients with dyspepsia compared with patients with peptic ulcer diathesis?

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