Changes In Gastrointestinal Mucosa Research Articles

Comparison of the Endoscopic Picture in Case of Complications of the upper Gastrointestinal Tract Caused by the Use of Antithrombotic Agents and Non-Steroidal Anti-Inflammatory Drugs

Intaking antithrombotic funds (ATA) and non-steroidal anti-inflammatory drugs (NSAIDs) is one of the most frequent causes of pathology in gastrointestinal (GI) tract.The purpose of the study: comparison of pathological changes of the mucous membrane in the upper GI tract, that occur against the background of ATA and NSAIDs admission.Material and methods. Endoscopic data of two groups of patients taking ATA and NSAIDS have been compared. The first group of 448 patients from the 10th Gastrointestinal Department in N.N. Burdenko Main Military Clinical Hospital was on record from 2013 to 2017. The patients had erosive ulcerous changes of gastrointestinal mucosa, occurred against the background of the ATA admission. The second group comprised 6431 patients with rheumatic diseases. They were hospitalized in the clinic of V.A. Nasonova Research Institute of Rheumatology in the period from 2007 to 2016 and took NSAIDs regularly.Results. Duodenal and gastric ulcer changes in gastric mucosa and duodenal ulcers were identified in 168 (37.5 %) patients taking ATA and in 1691 (26.3 %) patient treated with NSAIDS. Structure of pathology varied. So, against the background of ATA and NSAIDS admission, the number of acute gastric ulceration amounted to 6.5 % and 15.5 % (p < 0.001); acute ulcers duodenal was 2.9 % and 4.9 %; combined ulcerative lesions of gastric and duodenal was 2.9 % and 2.0 %; multiple erosions of gastroduodenal mucosa were 52.4 % and 15.7 % (p < 0.001); single erosion was 35. 1% and 61.6 %. The factor of ulcer history and age ≥ 65 years old increased significantly the risk of duodenal and gastric ulcer changes in patients taking ATA and NSAIDs: OR 5.182 (95% CI 2.701–9.942) and 3.24 (95% CI 2.19–5.34), 4.537 (95% CI 2.036–10.11) and 2.016 (95% CI 1.230–2.917) respectively. Intaking of proton pump inhibitor (PPI) reduced significantly the risk of complications for both ATA and NSAIDs: OR 0.329 (95% CI 0.199–0.546) and 0.317 (95% CI 0.210–0.428) respectively.Conclusion. The structure of pathology of mucous in the upper gastrointestinal tract that arose against the backdrop of ATA and NSAIDs admission is different. The first is characterized by a multiple erosion, while the second one has single acute distal gastric ulcers. The ulcerative history and advanced age of patients increase significantly the risk of complications concerning the gastroduodenal mucosa when using ATA and NSAIDs. PPI is the effective means of preventing this pathology.

AB0446 Gastrointestinal bleeding in adult patients with henoch-schönlein purpura

BackgroundAdult Henoch-Schönlein purpura (HSP) has a significantly higher frequency of gastrointestinal (GI) bleeding, compared with childhood HSP. However, the clinical characteristics of GI bleedings in adult HSP are still largely...

Investigation of gastro protective activity of Xanthium strumarium L. by modulation of cellular and biochemical marker

Peptic ulcer owes its pathological features to disregulated oxido-nitrosative and necrotic changes in gastrointestinal mucosa. Xanthium strumarium L. is a ubiquitous, abundant herb possessing an array of pharmacological properties. In view of anti-inflammatory and antioxidant activity of Xanthium strumarium L., the present investigation was designed to unravel its antiulcer potential in pylorus ligation induced gastric ulcer in laboratory animals. X. srtumarium L. leaves were extracted by refluxing with 95 % ethanol to obtained X. srtumarium L. ethanolic extract (XSEE). After 1 h pretreatment period of XSEE (100, 200 and 400 mg/kg) gastric ulcer was induced by ligation of pylorus portion of stomach. Various parameters including volume of gastric fluid, pH of gastric fluid, free as well as total acidity were measured in the gastric fluid whereas ulcer area, ulcer index, mucin content, superoxide dismutase, myeloperoxidase, nitric oxide, total calcium, histamine level, membrane bound inorganic phosphate (Na-K-ATPase), TNF-α level, DNA fragmentation were determined in the gastric tissue. Pretreatment with XSEE (200 and 400 mg/kg) significantly and dose dependently (P < 0.01 and P < 0.001) decreased ulcer area, ulcer index, macroscopical gastric damage score, volume of gastric fluid, free acidity as well as total acidity and mucin content. It also significantly increased pH of gastric fluid. Rats treated with XSEE (200 and 400 mg/kg) significantly and dose dependently (P < 0.01 and P < 0.001) attenuated decreased level of superoxide dismutase, nitric oxide and Na-K-ATPase. It also significantly decreased level of myeloperoxidase, calcium and inflammatory cytokine i.e. TNF-α. XSEE treated rats showed significant reduction in the pylorus ligation induced apoptotic changes. The possible mechanism by which Xanthium strumarium exerts its gastro-protective action may be due to free radical quenching, DNA repair and down regulation of oxidative-nitrosative stress along with cytokines.

Circadian Variations of Gastrointestinal Mucosal Damage Detected with Transnasal Endoscopy in Apparently Healthy Subjects Treated with Low-Dose Aspirin (ASA) for a Short Period

In this study, transnasal endoscopy was used to observe the time-course changes of gastrointestinal mucosa with low-dose aspirin (ASA), and the preventive effect of rebamipide was compared with placebo. Twenty healthy H.pylori-negative subjects were divided between those receiving 100 mg aspirin with placebo, and those receiving 100 mg aspirin+300 mg rebamipide for 7 days daily. Transnasal endoscopy was performed at 0, 2, 6 and 24 hrs on the first day, and then on the third and seventh days. Ulcers, in the duodenum at 24 hrs and in the antrum at 72 hrs, improved with continuous ASA. Erosions were mainly observed in the duodenum; erosions amounted to 14 at 3 days and 19 at 7 days in the placebo group. No ulcers and some erosions were mainly observed in the duodenum; erosions amounted to 5 at 3 days and 3 at 7 days in the rebamipide group. In short-term gastrointestinal damage induced by ASA, damage was observed in the duodenum most frequently, and peak damage was at 24 hrs and 72 hrs. Almost all damage improved gradually in spite of continuous ASA. Rebamipide reduced the damage of low-dose aspirin-induced GI complications.

Role of melatonin in reducing water avoidance stress-induced degeneration of the gastrointestinal mucosa.

We investigated the role of melatonin on water avoidance stress (WAS)-induced degeneration of the gastric, ileal and colonic mucosa. Wistar albino rats were exposed to acute WAS (aWAS group) or chronic WAS (cWAS group). Before exposing animals to acute (aWAS + mel group) or chronic WAS (cWAS + mel group), 10 mg/kg melatonin was injected i.p. The stomach, ileum and colon samples were investigated under light and scanning electron microscope. Malondialdehyde (MDA) and glutathione (GSH) levels were also determined. In both aWAS and cWAS groups, the epithelium of stomach showed ulceration in some areas, dilatations of the gastric glands and degeneration of gastric glandular cells; prominent congestion of the capillaries after WAS was apparent. In the cWAS group, severe vascular congestion was observed along with degeneration of ileal and colonic epithelium. MDA levels were increased and GSH levels were decreased in all tissues in both the aWAS and cWAS groups. The morphology of gastric, ileal and colonic mucosa in both aWAS + mel and cWAS + mel groups showed that the indole significantly reduced degeneration of the gastrointestinal mucosa. Decreased MDA and increased GSH levels were observed in the WAS + mel groups. Based on the results, melatonin treatment significantly prevented WAS induced degenerative morphological and biochemical changes of gastrointestinal mucosa.

3408 Gastrointestinal endoscopy is helpful in long distance runner with gastrointestinal blood loss and/or anemia.

Gastrointestinal symptoms such as epigastric pain, heartburn, nausea, vomiting, abdominal pain, and diarrhea are not uncommon and also gastrointestinal bleeding has been observed in long distance runners. However there have been very few prospective studies to examine endoscopic changes of gastrointestinal mucosa associated with running. AIM : We prospectively studied endoscopic changes of gastrointestinal mucosa, to identify GI blood loss, and to evaluate anemia before and after running in long distance runners. METHODS : Sixteen male long distance runners (age:18.2 ± 1.5) participated in our study. All subjects practiced 100Km running training during a week and completed three running competition. All subjects completed a symptom questionnaire, stool occult blood test (LA Hemochaser, MIZUHO, Japan) and anemia study (hemoglobin, hematocrit, serum iron, total iron binding capacity(TIBC), ferritin) 7 days before and immediately after running. The upper gastrointestinal endoscopic examinations were done before and after 10Km competitive running. The runners with positive stool occult blood had colonoscopic examination. RESULTS : Abdominal pain (N=9), diarrhea (N=8), epigastric discomfort (N=7), epigastric pain (N=6), regurgitation (N=4), and vomiting (N=1) were noted. Erosive gastritis (N=11), esophagitis (N=6), nonspecific erythema with bile coated mucosa (N=5), and gastric ulcer (N=1) were found by the upper gastrointestinal endoscopy. Four subjects had positive fecal occult blood; multiple erosions at the splenic flexure(N=1) and rectal polyp(N=1) were present. In the pre-running samples, low serum ferritin without anemia(N=5) and low serum iron without anemia(N=4) were observed. Five subjects had iron deficiency anemia. In the post-running samples, There were no statistically significant change in hemoglobin, hematocrit, serum iron, TIBC, and ferritin. CONCLUSIONS : Gastrointestinal symptoms and gastrointestinal mucosal changes were observed more frequent among long distance runners than general population. Gastrointestinal endoscopy should be performed in long distance runner with gastrointestinal symptoms and/or anemia.

Enhanced intestinal absorption of an RGD peptide from water-in-oil microemulsions of different composition and particle size

The fibrinogen receptor antagonist SK&F 106760 is a water-soluble tetrapeptide ( M r 634) with very low oil/water partitioning and membrane permeability. Thus, the intraduodenal bioavailability of this peptide in the rat from a saline formulation was found to be less than 1%. Upon formulation, however, in w/o microemulsions of different composition and particle size, the intraduodenal bioavailability of SK&F 106760 was increased up to 29% depending on the microemulsion composition. There was no apparent correlation between the particle size of microemulsions (mean droplet diameter of 0.010–1.0 μm) and enhanced absorption. None of the investigated microemulsions induced gross changes in gastrointestinal mucosa at a dosing volume of 3.3 ml/kg. Lipids containing medium-chain fatty acids play a major role on the observed absorption enhancement. These findings further support the use of microemulsion formulations for oral drug/peptide delivery, provided however, that development issues with these systems are properly addressed.

Increased Tight Junction Width in Two Children with Ménétrierʼs Disease

Protein-losing enteropathy (PLE) and edema are usually the most prominent clinical features in children with Ménétrier's disease. However, the changes in gastrointestinal mucosa that can cause PLE have not been described yet in children. We studied by electron microscopy the mucosa of the gastric fundus, which is the site where macroscopic changes are most prominent, in two children with Ménétrier's disease. We found that tight junction width was increased to 10.5 +/- 0.94 nm (mean +/- 1 SD) in one child and to 9.7 +/- 0.7 in the other. Tight junction width returned to normal when PLE and edema subsided. These ultrastructural changes were similar to those described in adults with the disease, although the clinical course of Ménétrier's disease is very different in adults and in children. Both patients showed evidence of cytomegalovirus (CMV) infection, as indicated by increasing IgG antibodies against the virus or recovery of the virus in the urine. Although Helicobacter pylori was found in the antral mucosa of one patient, the clinical course of the disease was not related to this microorganism. We conclude that increased tight junction width plays a role in PLE seen in Ménétrier's disease in children and that CMV, rather than Helicobacter pylori, is associated with the disease.

Increased Tight Junction Width in Two Children with Ménétrier's Disease

SummaryProtein‐losing enteropathy (PLE) and edema are usually the most prominent clinical features in children with Ménétrier's disease. However, the changes in gastrointestinal mucosa that can cause PLE have not been described yet in children. We studied by electron microscopy the mucosa of the gastric fundus, which is the site where macroscopic changes are most prominent, in two children with Ménétrier's disease. We found that tight junction width was increased to 10.5 ± 0.94 nm (mean ± 1 SD) in one child and to 9.7 ± 0.7 in the other. Tight junction width returned to normal when PLE and edema subsided. These ultrastructural changes were similar to those described in adults with the disease, although the clinical course of Ménétrier's disease is very different in adults and in children. Both patients showed evidence of cytomegalovirus (CMV) infection, as indicated by increasing IgG antibodies against the virus or recovery of the virus in the urine. Although Helicobacter pylori was found in the antral mucosa of one patient, the clinical course of the disease was not related to this microorganism. We conclude that increased tight junction width plays a role in PLE seen in Ménétrier's disease in children and that CMV, rather than Helicobacter pylori, is associated with the disease.