Duodenal Ulcer Research Articles

Reduction of Helicobacter pylori cells in rural water supply using slow sand filtration

Helicobacter pylori is a microorganism that infects 60% of the population and is considered the main cause of atrophic gastritis, gastric and duodenal ulcers, and gastric cancer. Different emerging pathogens have been found in drinking water and their presence is considered to be an important public health problem. For this reason, it is necessary to carry out the validation of reliable technologies for this type of pathogens and evaluate their performance. This paper reports, for the first time, H. pylori reduction in a drinking water pilot plant of two slow sand filters (SSF). Inlet water was taken from a gravel filtration system of a rural water supply in Colombia and then inoculated with viable cells of H. pylori. By determining the Genomic Units (GU) through quantitative Polymerase Chain Reaction (qPCR), the concentration of GU/sample was measured. In the inlet water amplification for SSF1 and SSF2 were 5.13 × 102 ± 4.48 × 102 and 6.59 × 102 ± 7.32 × 102, respectively, while for the treated water they were 7.0 ± 5.6 and 2.05 × 101 ± 2.9 × 101 GU/sample for SSF1 and SSF2, respectively. The SSF pilot plant reached up to 3 log reduction units of H. pylori; therefore, since there is not an H. pylori contamination indicator and its periodic monitoring is financially complicated, the SSF could guarantee the drinking water quality necessity that exists in rural areas and small municipalities in developing countries, where infection rates and prevalence of this pathogen are high.

Prevalence of gastritis and gastric and duodenal ulcers in Russian Guard servicemen

Based on the annual statistical reports for 2018–2023 and the cumulative median prevalence of various studies in 2009–2020 in Russia, the prevalence of peptic ulcer with uncomplicated and complicated course and various forms of gastritis in servicemen of the Regardie of the North Caucasian District was estimated, and the current trends are explained. The incidence of peptic ulcer with uncomplicated and complicated course and various forms of gastritis among the servicemen of the Regardie of the North Caucasian District for the specified period ranged from 11.521% to 16.351% (confidence interval: 10.515–12.588 and 15.233–17.517, respectively) and from 27.212% to 51.889% (confidence interval: 25.791–28.669 and 50.316–53.460, respectively). Random effects analysis has demonstrated different true effect sizes relative to the overall average. The revealed statistical patterns are only the first stage in an ongoing study on the prevalence of upper gastrointestinal diseases among the servicemen of the Regardie of the North Caucasian District. In general, the prevalence of peptic ulcer disease, including with a complicated course, and various forms of gastritis among military personnel was 13.270% and 37.679%, respectively (confidence interval: 10.617–16.170 and 24.292–52.102, respectively), showing an upward trend. The expected prevalence of peptic ulcer and gastritis in 2023 was 16,351 and 51,889%, respectively, which is not accidental and depends on the impact of specific risk factors. The identification of risk factors enables the development of measures to prevent delayed complications of the pathology under study and improvement of health in servicemen of the Regardie of the North Caucasian District. Thus, the study of the health status of the general population and military personnel, in particular, and the effect of various environmental factors determines their social significance both in military medicine and the structure of the healthcare system.

Cost-effectiveness analysis of Anaprazole versus Ilaprazole for the treatment of duodenal ulcers in China.

Anaprazole, an innovative drug, has shown promise in initial clinical trials for patients with duodenal ulcers (DU) in China. This study aimed to evaluate the potential effects, safety, and cost-effectiveness of Anaprazole compared to Ilaprazole in the treatment of DU and the budgetary impact on the healthcare system. Two multicentre, randomized controlled trials were used as data sources. The efficacy and safety of Anaprazole and Ilaprazole were compared using an anchored matching-adjusted indirect comparison (MAIC). A cost-utility analysis (CUA) was performed using a Markov model. A budget impact analysis (BIA) was conducted to evaluate the impact on the expenditure of the Chinese healthcare system. Deterministic and probabilistic sensitivity analyses were undertaken to test the uncertainty. The study findings indicated that Anaprazole and Ilaprazole have similar efficacy and safety in treating DU (OR = 1.05; 95% CI, 0.94-1.01; p = 0.35; OR = 0.63; 95% CI, 0.39-1.08; p = 0.12). The ICUR was 2,995.41¥/QALY, which is below the WTP threshold. The CUA results showed that Anaprazole is a cost-effective intervention with a probability of 85% at a given threshold. The results demonstrated strong robustness in the sensitivity analysis. Anaprazole imposed a low burden on the Chinese healthcare budget in the BIA. Compared with Ilaprazole, Anaprazole has similar efficacy, safety, and high cost-effectiveness, while also impacting the total expenditure of the healthcare system. ClinicalTrials.gov, identifier NCT04215653 and NCT02847455.

<I>Helicobacter pylori</I> infection and dermatological diseases

Helicobacter pylori (H. Pylori), microaerophilic spiral-shaped Gram-negative bacteria which colonize the gastric mucosa of human population, is the leading causal factor in the development of a whole range of diseases of the gastroduodenal region (chronic gastritis, gastric and duodenal ulcer disease, MALT lymphoma and gastric adenocarcinoma). Since the discovery of H. pylori infection and the identification of its leading role in the development of a range of gastroenterological diseases, researchers have begun to actively study the potential trigger significance of this pathogen in the development of extragastric pathology. At the epidemiological level, H. pylori infection has been shown to be frequently associated with skin diseases such as rosacea, acne, chronic urticaria and psoriasis, although the clinical significance of these associations remains clouded. In fact, recent meta-analytic studies (2019–2024) demonstrate an increased risk of developing the above diseases in H. pylori-infected individuals with odds ratios ranging from 1.19 to 3.00. On the other hand, not all studies have showed that eradication therapy of this microorganism helps reduce the clinical severity of symptoms of skin diseases, which is hypothetically explained only by the trigger role of infection within the complex pathogenesis. In a modern light, such associations can be viewed in terms of pathogenetic findings through the implementation of the syndrome of increased epithelial permeability (SIEP). The chronic gastritis caused by H. pylori infection is believed to lead to increased permeability of the epithelial lining of the stomach, as well as the walls of the mucosal vessels and a higher exposure of bacterial and nutritional antigens in the systemic circulation, which can induce both local release of inflammatory mediators in tissues and systemic immunological reactions (autoimmune and inflammatory processes, formation of molecular mimicry-induced immune complexes and cross-reactive antibodies).

Comprehensive insights on treatment modalities with conventional and herbal drugs for the treatment of duodenal ulcers.

Areas of the body accessible to gastric secretions, such as the stomach and duodenum, are most commonly damaged by circumscribed lesions of the upper gastrointestinal tract mucosa. Peptic ulcer disease is the term for this illness (PUD). About 80% of peptic ulcers are duodenal ulcers, with stomach ulcers accounting for the remaining 20%. Duodenal ulcers are linked to the two primary results about Helicobacter pylori infection and COX inhibitor users. Additional causes might include drinking, smoking, stress, and coffee consumption. The indications and symptoms of a duodenal ulcer depend on the patient's age and the lesion's location. For duodenal ulcers, proton pump inhibitors (PPIs) are the usual course of treatment. This comprehensive study included an in-depth literature search in the literature and methods section using electronic databases such as PubMed, ScienceDirect, and Google Scholar. The search method included publications published from the inception of the relevant database to the present. Inclusion criteria included studies investigating different treatment options for duodenal ulcer disease, including traditional pharmacotherapy and naturopathic treatments. Data mining includes information on treatment techniques, treatment outcomes, and possible synergies between conventional and herbal treatments. In addition, this review critically examines the available information on the effectiveness, safety, and possible side effects of different treatments. The inclusion of conventional and herbal treatments is intended to provide a comprehensive overview of the many treatment options available for duodenal ulcer disease. A more comprehensive and personalized treatment plan can be achieved by incorporating dietary changes, lifestyle modifications, and, if necessary, herbal therapies to complement other treatments normally.

Clinical Application and Feasibility of Capsule Endoscopy in Children at a Medical Center in Central Taiwan

Background/PurposeCapsule endoscopy (CE) is a noninvasive examination for excellent visualization of small bowel mucosal lesions. We aimed to evaluate the clinical efficacy and safety of CE in pediatric patients. MethodsFrom April 2014 to December 2022, CE procedures performed in children younger than 18 years of age at Taichung Veteran General Hospital were analyzed retrospectively. ResultsAmong 136 procedures, the completion rate was 95.6% (n=130), with a median age of 14 years old. Suspicion or evaluation of inflammatory bowel diseases (IBD) (41%) was the most common indication for CE. Other common indications of CE were chronic unexplained abdominal pain (35%) and obscure gastrointestinal bleeding or iron deficiency anemia (21%). No procedure-related complications occurred. The diagnosis of those patients with incomplete study were CD with small bowel stricture, graft-versus-host disease and duodenal ulcers. A total of 86 CE procedures showed positive findings, and the overall diagnostic yield rate was 63.2%. Small bowel ulcers (65.12%) were the most common findings. Overall, 26.5% of CE examinations resulted in a new diagnosis and 44.9% of CE exams led to a change in therapy. For patients with IBD, CE findings resulted in an even higher therapeutic change rate of 48.1%. ConclusionsCE is a safe and feasible diagnostic method to study the small intestine in children, especially for IBD. Incomplete study could be an indicator of positive finding and can potentially be a guide to identify the site of possible strictures.

EE177 The Cost-Effectiveness Analysis of Anaprazole Versus Ilaprazole for Treating Duodenal Ulcers in China

EE177 The Cost-Effectiveness Analysis of Anaprazole Versus Ilaprazole for Treating Duodenal Ulcers in China

EE277 Budget Impact Analysis of Anaprazole for the Treatment of Duodenal Ulcer in China

EE277 Budget Impact Analysis of Anaprazole for the Treatment of Duodenal Ulcer in China

Gastrointestinal bleeding in children with Henoch-Schönlein purpura combined with prognostic nutrition index may predict endoscopic duodenal ulcers during hospitalization: A single-center retrospective case-control study.

Duodenal ulcer (DU) is the most common gastroscopic manifestation of abdominal Henoch-Schönlein purpura (HSP), which may cause severe bleeding and often requires esophagogastroduodenoscopy (EGD) to confirm the diagnosis. However, the condition of children with HSP changes rapidly; not all children are able to undergo EGD on time, and some hospitals do not have a pediatric EGD unit. Therefore, assessing the risk factors for developing DU in HSP using simple and readily available indicators is essential. Children with HSP at Wuhan Children Hospital from June 2020 to June 2022 were included in the training set and completed EGD. The patients were divided into 2 groups: those with (DU group) and without DU (non-DU group). Data were collected from the 2 groups, and univariate and multivariate logistic regression analyses were used to compare the 2 groups. Children with HSP admitted between July 2022 and June 2023 were included in the validation set. Four indicators, prognostic nutrition index, albumin (ALB), gastrointestinal (GI) bleeding, and duration of onset before EGD, were found in the DU and non-DU groups. GI bleeding and prognostic nutritional index (PNI) ≤ 53.0 have strong predictability for patients with HSP and DU. GI bleeding and PNI ≤ 53.0 may provide new reference evidence for condition assessment and treatment.

Evaluation of Antiulcer Potential of <i>Bougainvillea spectabilis</i> Extracts on Cysteamine Hydrochloride-Induced Duodenal Ulceration in Rats

Evaluation of Antiulcer Potential of <i>Bougainvillea spectabilis</i> Extracts on Cysteamine Hydrochloride-Induced Duodenal Ulceration in Rats

The protective effects and potential mechanisms of fulvic acid against ethanol-induced gastric mucosal injury in mice

Fulvic acid (FA) is a kind of natural organic acids extracted from lignite, which is the active ingredient in Wujin oral liquid, a proprietary Chinese medicine used to treat gastric and duodenal ulcers. However, our understanding of the mechanisms of FA remains limited. Currently, the protection of FA and its mechanism were explored using the ethanol-induced gastric mucosal injury mouse model. The histopathological examinations showed FAs at three doses effectively reduced gastric congestion, oedema caused by ethanol, and prevented gastric epithelial cell fall-off. When compared to the model group, FAs reduced IL-1β and IL-6 levels in serum, as well as IL-1β, IL-6, TNF-α, and COX-2 expression levels in tissue. Furthermore, FAs significantly inhibited p65, P38 MAPK, and Erk1/2 phosphorylation in damaged gastric tissue. It was indicated FA has good protection against ethanol-induced gastric mucosa injuries in mice and this effect was related to NF-κB and MAPK signalling pathways.

Characterization of the chemical constituents of Croton crassifolius Geisel extract and plasma pharmacokinetics of 6 terpenoids after oral administration by UPLC-Q/TOF-MS.

Croton crassifolius Geisel. (CCG) is a traditional Chinese medicine widely used in South China. It has various pharmacological effects and is often used in treating rheumatoid arthritis and gastric and duodenal ulcers. However, the chemical characteristics and its effective constituents are still scarcely studied. To determine the phytochemical profile of the CCG extract and to investigate the chemical characteristics of terpenoids extracted from rat plasma following oral administration of CCG extract based on UPLC-Q/TOF-MS. Moreover, six terpenoids in CCG were quantified, and in vivo pharmacokinetic behavior after oral CCG extract was further explored. In total, 56 terpenoids were tentatively identified in the CCG extract and 16 terpenoids were detected in rat plasma after oral CCG extract. In addition, the contents of six terpenoids in CCG were clarified. The plasma quantification method of six terpenoids was further established, validated, and confirmed to have good sensitivity and specificity. The six analytes exhibited excellent linearity in respective concentration ranges (r ≥ 0.998). The intra-day and inter-day precisions relative standard deviation (RSD, %) were less than 11.27%, and the accuracies ranged from -7.06% to 9.91%. Stability, extraction recovery, and matrix effect in plasma were within the required limits (RSD < 15%). A total of 56 terpenoids were identified in CCG and 16 prototype components in plasma after oral CCG. The validated quantitative method was successfully applied to the simultaneous determination of six major terpenoids in plasma. The pharmacokinetic parameters are clarified, which can guide the clinical application of CCG.

IMMEDIATE RESULTS OF MINIMALLY INVASIVE SURGERY FOR COMPLICATED PEPTIC ULCERS OF THE STOMACH AND DUODENUM

Objective: To enhance the immediate treatment outcomes of complicated peptic ulcers of the stomach and duodenum through the development and application of video-assisted organ-preserving surgeries. Materials and Methods: This study analyzed the treatment outcomes of 261 patients with complicated gastric and duodenal ulcers. The patients received the treatment in the surgical departments of Azerbaijan State Advanced Training Institute for Doctors named after A. Aliyev, Scientific Surgical Center named after M.A. Topchubashev, and Sabunchi Medical Center from 2015 to 2023. All patients with perforated and bleeding ulcers of the stomach and duodenum underwent clinical and instrumental examinations. The initial general condition of the patient was thoroughly assessed. Among the patients, there were 220 men (84.3%) and 41 women (15.7%), with ages ranging from 18 to 84 years. There were 75 (28.7%) patients complicated with bleeding of gastric and duodenal ulcer, and 186 (71.3%) patients with perforation. In the control group, traditional, "open" surgical interventions were performed in 164 (62.8%) patients, and minimally invasive endoscopic video-assisted operations were performed in 97 (37.2%) cases. Out of 186 patients, 124 (66.7%) underwent traditional suturing of a perforated gastroduodenal ulcer during laparotomy, while 62 (33.3%) underwent minimally invasive endosurgical interventions. In the control group, 12 (8.4%) patients underwent gastric resection, and 10 (5.4%) underwent vagotomy with pyloroplasty. The immediate results of radical operations for a perforated ulcer were characterized by a high percentage of early complications, with 5 (41.6%) cases. Results. Of the 186 patients operated on for perforated gastroduodenal ulcer, 12 individuals (6.5±2.9%) developed complications in the postoperative period: 9 (7.3%) in the comparison group, and 3 (4.8%) patients in the main group. We obtained a statistically significant shorter duration of a surgical intervention by 24.8 minutes and shorter hospital staying time due to a decrease in the duration of the postoperative period by 5.3 days, a lower number of postoperative complications by 2.5%, and a lower postoperative mortality by 2.4%. The duration of laparoscopic suturing of a perforated ulcer averaged 38.6 minutes. The duration of hospital staying averaged 6.9±1.2 days. The use of minimally invasive interventions for ulcerative duodenal bleeding was accompanied by a significant reduction in the rehabilitation period compared with that after traditional, "open" operations that amounted to 18.3+3.6 and 35.5±5.9 days, respectively. Postoperative mortality was 1.3% (1 patient in the control group died). Conclusion. The outcome of treatment depends on the age of patients, the timing of the onset of the disease, the severity of concomitant pathology, the severity and extent of peritonitis and the duration of ulcerative anamnesis.

Frequency of Different Causes of Upper GI Bleed Using Endoscopic Procedure

Background: Upper gastrointestinal (GI) bleeding is a significant clinical emergency that necessitates swift and precise diagnostic and therapeutic interventions. Due to its diverse etiologies, ranging from peptic ulcers to variceal bleeding, understanding these causes is crucial for effective management. Objective: To evaluate the prevalence of various causes of upper GI bleeding through endoscopic examination. Methods: This descriptive cross-sectional study was conducted at the Department of Gastroenterology, Asian Institute of Medical Sciences (AIMS), Hyderabad, involving 150 hemodynamically stable patients who had fasted for 6 to 8 hours. A comprehensive physical examination and detailed medical history preceded the endoscopic procedures. Data were captured on a structured proforma and analyzed using SPSS software, version 26.0. Results: The cohort's mean age was 50.35 years (range 18-85 years), with a male predominance of 72%. Variceal bleeding was the most common finding (64.7%), followed by peptic ulcers (24%), Mallory-Weiss tears (12.7%), vascular anomalies (13.3%), gastric ulcers (7.3%), duodenal ulcers (6%), erosive gastritis (3.3%), and esophagitis (2.7%). Conclusion: Upper GI bleeding predominantly affects older adult males, with variceal bleeding accounting for about two-thirds of cases. The diversity of underlying causes highlights the need for accurate diagnostics and tailored treatments for high-risk groups.

Astragaloside IV ameliorates indomethacin-induced intestinal inflammation in rats through inhibiting the activation of NLRP3 inflammasome

The administration of nonsteroidal anti-inflammatory drugs (NSAIDs) may cause significant intestinal alteration and inflammation and lead to the occurrence of inflammatory diseases resembling duodenal ulcers. Astragaloside IV (AS-IV) is a glycoside of cycloartane-type triterpene isolated from the dried root of Astragalus membranaceus (Fisch.) Bge. (family Fabaceae), and has been used for ameliorating the NSAID-induced inflammation in the small intestine. The present study aimed to investigate the effects of AS-IV on indomethacin (IND)-induced inflammation in the small intestine of rats and its underlying mechanisms. Hematoxylin-eosin (H&E) staining, transmission and scanning electron microscopy were carried out to observe the surface morphology and ultrastructure of the small intestinal mucosa. Immunofluorescence and ELISA tests were employed to detect the expressions of NLRP3, ASC, caspase-1, and NF-κB proteins, as well as inflammatory factors IL-1β and IL-18, to uncover potential molecular mechanisms responsible for mitigating small intestinal inflammation. The results demonstrated that AS-IV significantly decreased the ulcer index, improved the surface morphology and microstructure of the small intestinal mucosa, and increased mucosal blood flow. Molecular docking revealed a strong and stable binding capacity of AS-IV to NLRP3, ASC, caspase-1, and NF-κB proteins. Further experimental validation exhibited that AS-IV markedly decreased levels of IL-1β and IL-18, and inhibited the protein expression of NLRP3, ASC, caspase-1, and NF-κB. Our data demonstrate that AS-IV ameliorates IND-induced intestinal inflammation in rats by inhibiting the activation of NLRP3 inflammasome and reducing the release of IL-1β and IL-18, thereby representing a promising therapy for IND-induced intestinal inflammation.

(-)-Fenchone Prevents Cysteamine-Induced Duodenal Ulcers and Accelerates Healing Promoting Re-Epithelialization of Gastric Ulcers in Rats via Antioxidant and Immunomodulatory Mechanisms.

(-)-Fenchone is a naturally occurring monoterpene found in the essential oils of Foeniculum vulgare Mill., Thuja occidentalis L., and Peumus boldus Molina. Pharmacological studies have reported its antinociceptive, antimicrobial, anti-inflammatory, antidiarrheal, and antioxidant activities. The preventive antiulcer effects of (-)-Fenchone were assessed through oral pretreatment in cysteamine-induced duodenal lesion models. Gastric healing, the underlying mechanisms, and toxicity after repeated doses were evaluated using the acetic acid-induced gastric ulcer rat model with oral treatment administered for 14 days. In the cysteamine-induced duodenal ulcer model, fenchone (37.5-300 mg/kg) significantly decreased the ulcer area and prevented lesion formation. In the acetic acid-induced ulcer model, fenchone (150 mg/kg) reduced (p < 0.001) ulcerative injury. These effects were associated with increased levels of reduced glutathione (GSH), superoxide dismutase (SOD), interleukin (IL)-10, and transforming growth factor-beta (TGF-β). Furthermore, treatment with (-)-Fenchone (150 mg/kg) significantly reduced (p < 0.001) malondialdehyde (MDA), myeloperoxidase (MPO), interleukin-1 beta (IL-1β), tumor necrosis factor-alpha (TNF-α), and nuclear transcription factor kappa B (NF-κB). A 14-day oral toxicity investigation revealed no alterations in heart, liver, spleen, or kidney weight, nor in the biochemical and hematological parameters assessed. (-)-Fenchone protected animals from body weight loss while maintaining feed and water intake. (-)-Fenchone exhibits low toxicity, prevents duodenal ulcers, and enhances gastric healing activities. Antioxidant and immunomodulatory properties appear to be involved in its therapeutic effects.

Features Of The Occurrence Of Helicobacter Pylori Infection With Gastroduodenal Pathology In Children

Despite the presence of studies devoted to the study of the bacterium Helicobacter pylori, its role in the pathogenesis of diseases such as chronic gastritis, gastric and duodenal ulcers, MALT lymphoma and gastric adenocarcinoma, the question of what determines the development of one or another clinical form of gastroduodenal pathology remains open. One of the factors with which the characteristics of clinical forms of Helicobacter pylori-associated diseases are usually associated is the genetic characteristics of the microorganism, which determines its virulence

Neuropsychological and psychometric parameters in the patients with duodenal ulcer depending on Helicobacter pylori presence

Neuropsychological and psychometric parameters in the patients with duodenal ulcer depending on Helicobacter pylori presence

Integrated models of population pharmacokinetics and exposure response to optimize dosage regimen for anaprazole sodium in duodenal ulcer

Anaprazole sodium enteric-coated tablet is a novel proton pump inhibitor which has been approved for the treatment of duodenal ulcer. The aim of this study is to provide reliable information for the design of an optimal dosage regimen. Population pharmacokinetics and exposure-response models were integrated to evaluate the pharmacokinetic parameters and covariates of Anaprazole and its metabolite M21-1, and subsequently provided dosage suggestions based on clinical trials and simulation data. A pharmacokinetic model incorporating two-compartment for the parent drug and one-compartment for the metabolite, with both first-order and zero-order mixed absorption was used to describe the pharmacokinetics of Anaprazole and M21-1. Age emerged as a significant covariate affecting the elimination rate constant of M21-1, with clearance decreasing as age advances. No correlation was observed between the pharmacokinetics of Anaprazole or M21-1 and the adverse reactions under the current dosages. BMI might be the influence factor of the mild gastrointestinal adverse reactions. Meanwhile, Anaprazole had a good healing rate (94.0 %) in duodenal ulcer patients and the exposure-response analysis indicated that the cured results were not influenced by the exposure parameters of parent drug or metabolite. In conclusion, the drug is safe when dosing between 20 and 100 mg once a day.

КЛИНИКО-ДИАГНОСТИЧЕСКОЕ ЗНАЧЕНИЕ УРОВНЕЙ IL-1β У ДЕТЕЙ С ЯЗВЕННОЙ БОЛЕЗНЬЮ ДВЕНАДЦАТИПЕРСТНОЙ КИШКИ И ЭРОЗИВНЫМИ ГАСТРОДУОДЕНИТАМИ

Today, duodenal ulcer and chronic gastroduodenitis represent a serious problem in clinical medicine. According to modern medical reviews, despite the undoubted commonality of pathogenetic mechanisms, deviation in the implementation of duodenal ulcer or erosive gastroduodenitis is largely dictated by a genetically predetermined variant of the cytokine response.