Gastric Mucosal Ulceration Research Articles

Fermented Unripe Plantain Juice Ameliorates Diclofenac-Induced Hepatic and Renal Dysfunction in Wistar Rats

Diclofenac administration has been associated with several health problems in human including gastrointestinal tract problems, renal toxicity, among others. Several medicinal plants are been used locally for the treatment of several diseases. The aim of this study was to investigate the potential of fermented unripe plantain juice (FUPJ) in ameliorating diclofenac-induced ulcer and renal dysfunction. Twenty (20) healthy adult Wister rats weighing between 110g to 200g were randomly divided into four groups of five rats each. Group I served as control, received distilled water and feeds, Group 2 received 10mg/kg body weight of diclofenac only, Group 3 received 10mg/kg body weight of diclofenac only and post treated with 200mg/kg body weight of FUPJ and Group 4 received 200mg/kg body weight of FUPJ. The diclofenac was administered IP and fermented unripe plantain extract was administered orally for fourteen (14) days. The results showed that diclofenac administration caused a significant increase (p<0.05) in serum levels of creatinine and a significant decrease (p<0.05) in antioxidant enzymes (superoxide dismutase, catalase, and glutathione peroxidase) compared to the control group. Additionally, diclofenac administration caused ulceration in the gastric mucosa. However, treatment with FUPJ significantly reduced (p<0.05) the levels of creatinine, urea, and MDA and increased (p<0.05) the levels of antioxidant enzymes in a dose-dependent manner. The highest dose of FUPJ (200mg/kg) showed the most significant reduction in the levels of the tested parameters and prevented the gastric mucosal ulceration. In conclusion, FUPJ has the potential to ameliorate diclofenac-induced ulcer and renal dysfunction through its antioxidant and anti-inflammatory properties.

Protective effect of Enterococcus faecium against ethanol-induced gastric injury via extracellular vesicles.

Recently, Enterococcus has been shown to have gastric protective functions, and the mechanisms by which Enterococcus modulates gastric function are still being investigated. Herein, we investigated how Enterococcus faecium (Efm) and E. faecium-derived extracellular vesicles (EVs) (EfmEVs) exert protective effect against ethanol-induced gastric injury by investigating the effect of EfmEVs on gastric mucosal ulcer scoring, histological lesion, mucosal glycoprotein production, acidity, anti-oxidative function, and inflammatory responses in rat. Pretreatment with Efm showed significant reduction of ethanol-induced gastric injury, as evidenced by the lowering of ulcer index, histological lesion, gastric pH, and inflammatory responses and the enhancement of mucosal glycoprotein production and anti-oxidative function. Further functional studies on three bioactive components [inactivated Efm, EfmEVs (EVs), and EV-free supernatants] of the bacterial culture showed that EVs are mostly responsible for the gastroprotective effect. Moreover, EV secretion is beneficial for the gastroprotective effect of Efm. Hence, EVs mediated the protective effect of Efm against ethanol-induced gastric injury by lowering inflammatory responses and enhancing anti-oxidative function and may be a potent anti-inflammatory and anti-oxidative strategy to alleviate hyperinflammatory gastrointestinal tract conditions.IMPORTANCEThis study indicated that Enterococcus faecium provided a protective effect against rat gastric injury, which involved improvement of the mucosal glycoprotein production, anti-oxidative function, and inflammatory responses. Furthermore, we confirmed that three bioactive components (inactivated Efm, extracellular vesicles, and EV-free supernatants) of E. faecium culture also contributed to the gastroprotective effect. Importantly, E. faecium-derived EVs showed an effective impact for the gastroprotective effect.

Establishment and Evaluation of a Risk Prediction Model for Pathological Escalation of Gastric Low-Grade Intraepithelial Neoplasia.

The study aims to explore the risk factors for pathological escalation after endoscopic surgery for gastric low-grade intraepithelial neoplasia (LGIN) and to establish and evaluate a risk prediction model for LGIN. A total of 120 patients diagnosed with gastric LGIN by biopsy and endoscopic submucosal dissection (ESD) between November 2020 and June 2022 were retrospectively analyzed. Gender, age, Helicobacter pylori (HP) infection, lesion size, lesion location, morphology, gastric mucosal congestion, nodules status, surface ulceration and erosion, and ME-observation of all patients were collected and divided into upgraded and non-upgraded groups according to the biopsy and ESD postoperative pathological diagnosis results. Independent risk factors for pathological escalation after ESD surgical treatment were screened by logistic regression analysis, and a risk prediction model was established. Among the 120 patients with gastric LGIN, 49 patients developed postoperative pathological upgrading; the rate of pathological upgrading was 40.83%. Among them, 42 patients were upgraded to high-grade intraepithelial neoplasia (HGIN), 1 case was upgraded to advanced gastric cancer, and 6 cases were upgraded to early gastric carcinoma (EGC). Univariate analysis showed that age, lesion size, gastric mucosal congestion, surface ulcers, and erosion were significantly different between the groups (p < 0.05). Multivariate Logistic regression analysis revealed that age ≥60 years, focal length ≥2 cm, gastric mucosal congestion, and surface ulceration and erosion were independent risk factors for postoperative pathological escalation in patients with gastric LGIN. Final joint probability forecasting model for P = 1/[1 + e(26.515-0.161 x β1-0.357 x β2+0.039 x β3-0.269 x β4)]. Age, lesion size ≥2 cm, gastric mucosal congestion, and lesion surface ulceration and erosion are risk factors for postoperative pathological upgrading in patients with gastric LGIN. The risk prediction model established in this study based on risk factors has predictive value and can provide a scientific reference for the clinical treatment of patients with gastric LGIN.

Colonic Duplication Cyst with Gastric Heterotopia Haemorrhage and Mucosal Ulceration: A Case Report

Present report relates to duplication of ascending colon with cyst formation along with ectopia of gastric glands in lamina propria of colon. Heterotopia or ectopia is defined as presence of an organ outside its normal anatomic site. Ileum is the commonest site of heterotopia in gastrointestinal tract. Rarely, heterotopia may involve ascending colon. In the present case, cyst wall also had a thickened area, measuring 1×1×0.5 cm, consisting of hypertrophic muscularis. Cyst wall showed ulceration in continuity with colonic columnar epithelium. In addition, lamina propria also showed mixed leucocytic infiltration. The lesion was finally diagnosed as duplication of ascending colon with cyst formation and heterotopia of benign gastric glands, hemorrhage and ulceration. Keywords: Large intestinal cyst with two corresponding parts, ectopia of gastric glands with ulceration and haemorrhage.

Retraction: Gastroprotective Activity of Ethyl-4-[(3,5-di-tert-butyl-2-hydroxybenzylidene) Amino]benzoate against Ethanol-Induced Gastric Mucosal Ulcer in Rats.

Retraction: Gastroprotective Activity of Ethyl-4-[(3,5-di-tert-butyl-2-hydroxybenzylidene) Amino]benzoate against Ethanol-Induced Gastric Mucosal Ulcer in Rats.

Retraction: Biochanin A Gastroprotective Effects in Ethanol-Induced Gastric Mucosal Ulceration in Rats.

Retraction: Biochanin A Gastroprotective Effects in Ethanol-Induced Gastric Mucosal Ulceration in Rats.

Effects of Vitamin B on experimentally induced gastric ulcers in rodents

Background: Peptic ulcer disease (PUD) is associated with water soluble vitamin deficiencies. B group vitamins play vital roles in maintenance of essential body functions. PU patients are found to present with Vitamin B deficiency and high rates of Helicobacter pyloric infection. This study aims to investigate the effect of vitamin B (VB) on experimentally induced gastric ulcers in mice Method: Gastric ulcers were induced in adult Swiss albino mice using absolute ethanol, a nonsteroidal anti-inflammatory agent, diclofenac and acetic acid. Animal were treated for 7 days with vitamin B at 12.5, 25 and 50 mg/kg before ulcer induction with ethanol and diclofenac, while in the acetic acid induced ulcers, treatment (VB 50 mg/kg) was administered for 14 and 28 days post ulcer induction. The degree of gastric ulceration was scored after which tissues subjected to histological analysis Results: The results showed that vitamin B ameliorated ulceration caused by absolute ethanol, diclofenac and acetic acid. In the ethanol induce ulcer, pretreatment with VB produced dosedependent reduction in severity of ulcer when compared to control group. Ulceration of gastric mucosa was inhibited by 3.57%, 23.86% and 55.71% at 12.5, 25 and 50 mg/kg of VB respectively. Omeprazole produced an inhibition of 69.71% at 20mg/kg. VB similarly inhibited diclofenac induced ulceration by 54.31%, 69.05% and 78.94% respectively at tested doses, while omeprazole had 87.79%. For the acetic acid-induced ulcer animals, treatment significantly increased pH of gastric contents when compared with control. Histological analysis revealed dose-dependent (ethanol and diclofenac) and time - dependent (Acetic acid) decrease in severity of damage caused by the ulcerogens on treatment with VB Conclusion: These findings suggest that vitamin B possesses potential gastro-protective effects.

Effectiveness of natural biomaterials in the protection and healing of experimentally induced gastric mucosa Ulcer in rats

BackgroundA gastric ulcer is a painful lesion of the gastric mucosa that can be debilitating or even fatal. The effectiveness of several plant extracts in the therapy of this illness has been demonstrated in traditional pharmacopoeias. Aim: this study was aimed to see if propolis, ginseng in normal or nano form, and amygdalin might help in preventing the ulcerative effects of absolute ethanol.MethodsGastroprotective properties of pretreatments before ethanol gavage in rats were compared to omeprazole. The ulcer and stomach parameters (ulcerated regions) were measured (mm2), ulcer inhibition percentage, the stomachs were assessed macroscopically with gastric biopsy histological examinations.ResultsAmygdalin, normal and nano ginseng, nano propolis followed by propolis all showed great efficacy in protecting the cyto-architecture and function of the gastric mucosa. The number of ulcerated sites was greatly reduced, and the percentage of stomach protection was increased. Histopathological examination had confirmed great protective effects of the nanoformulations followed by amygdalin. The protection and healing rate was completed to about 100% in all tested materials while ulcer areas were still partially unhealed in normal propolis and omeprazole. Quantitative assay of the m-RNA levels Enothelin 1(ET-1), leukotriene4 (LT-4), and caspase 3(Cas-3) genes and Histamine were done and revealed significant up-regulations in ethanol group and the maximum protective effect was reported with ginseng nano, moreover the histamine content was significantly decreased with nano- formulated extracts.ConclusionAmygdalin and the nanoformulated ginseng and propolis had exhibited a marked protective effect against the ulcerative toxic effects of ethanol.

Evaluation of Acetic Acid-Induced Chronic Gastric Ulcer Healing by Propionyl-L-Carnitine Administration.

The aim of our study was to investigate the healing effect of propionyl-L-carnitine (PLC) on chronic gastric ulcers and its underlying mechanisms. This study included rats with gastric ulcers induced by applying serosal glacial acetic acid. These rats were then given either saline (vehicle) or PLC at doses of 60 and 120 mg/kg, administered orally 3 days after ulcer induction for 14 consecutive days. Our study found that treatment with PLC resulted in a reduction of the gastric ulcer area, a faster rate of ulcer healing, and stimulated mucosal restoration. Additionally, the treatment with PLC reduced the number of Iba-1+ M1 macrophages while increasing the number of galectin-3+ M2 macrophages, as well as desmin+ microvessels, and α-SMA+ myofibroblasts in the gastric ulcer bed. The mRNA expression of COX-2, eNOS, TGF-β1, VEGFA, and EGF in the ulcerated gastric mucosa was greater in the PLC-treated groups compared with the vehicle-treated rats. In conclusion, these findings suggest that PLC treatment may accelerate gastric ulcer healing by stimulating mucosal reconstruction, macrophage polarization, angiogenesis, and fibroblast proliferation, as well as fibroblast-myofibroblast transition. This process is associated with the upregulation of TGF-β1, VEGFA, and EGF, as well as modulation of the cyclooxygenase/nitric oxide synthase systems.

Gastroprotective and Antioxidative Effects of Ammi Visnaga Extract Against Ethanol-induced Gastric Mucosal Ulceration in Male Albino Rats

Background: Alcohol abuse contributes to the pathology of gastric ulcers. The tissues contain antioxidants, but the activity declines when exposed to reactive oxygen species. The Ammi visnaga extract has substantial scavenging effects and is rich in phenols and flavonoids. We estimated the gastro-protective and antioxidative effects of A. visnaga extract on rats’ gastric mucosal lesions after exposure to ethanol. Methods: Forty adult male albino rats were divided into four groups of ten each. Group 1 (standard control), group 2 received omeprazole 20 mg/kg+1 mL ethanol, group 3 (ulcer model) received 1 mL ethanol 80% only, and group 4 received 1200 mg/kg/day A. Visnaga extract+1 mL ethanol 80%. The gastric pH, percentage of ulcer area, gastric mucus secretion, oxidative and antioxidant markers, and histopathology were examined in each group. Results: Pre-treatment with omeprazole and A. visnaga extract improved the gastric acidity, the ulcerated areas, and the gastric mucus secretion compared to the rats in group 3. Compared to group 3, rats treated with omeprazole and A. visnaga extract showed major improvements in the tissue glutathione, superoxide dismutase, and catalase levels. The histopathology examinations showed ulceration of the glandular mucosa in group 3, accompanied by multifocal inflammatory cell infiltrations. The omeprazole treatment completely protected the gastric mucosa in group 2. Significant improvement was also observed in rats pretreated with A. visnaga extract (group 4). Conclusion: The gastro-protective effects of A. visnaga extract included the inhibition of tissue oxidative stress and increased the antioxidant properties.

Endoscopic findings in the upper gastrointestinal tract in patients with Crohn’s disease are common, highly specific, and associated with chronic gastritis

Crohn’s disease (CD) may affect the entire gastrointestinal tract including its upper part. However, this aspect is poorly addressed in scientific literature and considered a rare finding. Here we aimed to prospectively investigate the prevalence, characteristics and clinical significance of upper gastrointestinal tract involvement in patients with CD, with particular focus on stomach bamboo joint-like appearance (BJA), Helicobacterpylori status and presence of microscopic changes. 375 prospectively recruited patients were included. In CD patients the prevalence of gastric and duodenal, but not esophageal, mucosal lesions, such as gastric mucosal inflammation, duodenal edema, ulcerations, and duodenal bulb deformation was significantly higher (at least p < 0.01 for all). Similar results were found when only H.pylori negative individuals were analyzed. Moreover, BJA of the stomach and in case of H.pylori negative patients also duodenal bulb deformation were detected exclusively in CD patients. Presence of BJA lesion was not significantly associated with neither duration of the disease nor use/history of biologic treatment. Despite absence of H.pylori infection microscopic features of chronic gastritis were found in almost all (93.5%) patients, and in 31% of controls (p < 0.00001). Our analysis outlines that upper gastrointestinal tract involvement in CD is a very common event and frequently manifests with a highly specific BJA lesion. Furthermore, our study reveals that in almost all CD patients features of H.pylori negative gastritis are present.

S3605 Gastrointestinal Stromal Tumor Presenting as a Fistulizing Cavitary Lesion

Introduction: Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal neoplasms of the stomach. GISTs can vary from small, asymptomatic lesions managed with surveillance to large lesions presenting with life-threatening complications, including gastrointestinal hemorrhage. Complications such cavitary lesions and luminal GI fistulas have been reported but are exceedingly rare. Case Description/Methods: A 65 year-old woman developed mild, constant abdominal pain. Her past medical history includes HTN, GERD, COPD and 50 pack-year smoking history. One month after symptom onset, she was admitted to an outside hospital with upper GI bleed. EGD was reportedly normal at that time. She was readmitted one month later with recurrent anemia. CT scan showed a large gastric diverticulum or possible cavitary lesion. EGD was repeated and showed an opening to a large diverticulum or cavity distal to the gastroesophageal junction with ulcerated cavity wall. Pathology showed ulcerated gastric mucosa and granulation tissue with atypical spindle cells. Biopsies were negative for H. pylori. She was then admitted to our hospital for severe anemia and work-up of suspected GIST. A third EGD showed a 2 cm fistula to a 10 cm necrotic cavity on the fundus and proximal greater curvature of the gastric body. Multiple biopsies of the cavity wall were taken. Biopsies were positive for spindle cell-type GIST (CD117+, CD34+, Cam 5.2-). She then had a feeding jejunostomy placed due to difficulty tolerating PO intake. She was treated with pantoprazole and imatinib and discharged with Medical Oncology and Surgery follow-up for resection. (Figure) Discussion: The most common site of origin for GISTs is the stomach. Radiographic appearance is variable and can include endoluminal, exophytic or dumbbell-shaped pattern and there is frequently necrosis. Other imaging findings include calcifications, cyst formation, cystic degeneration and rarely, cavitary lesions and fistulas. In fact, there are only 2 case reports in the last 10 years of GISTs presenting as a gastric fistula or a gastrobronchial fistula. CT findings including: hemorrhage, necrosis, calcifications, intralesional cavitation, cystic degeneration, size >10cm, irregular margins and heterogeneous enhancement all portend a poor prognosis. Enlarged feeding or draining vessels can predict relapse. Our patient’s case shows that it is important to have a high index of suspicion for diagnosis of GIST, particularly in the setting of atypical presentation.Figure 1.: Upper GI endoscopy image of the interior of the GIST cavity.

Circumferential Gastric Wall Thickening With Lymphadenopathy

Question: A 78-year-old Japanese man with a history of hypertension and abdominal aortic aneurysm visited our hospital for epigastric discomfort lasting more than a week. Blood examination revealed mildly elevated white blood cell counts (9900/μL) and normal red blood cell and platelet counts. Biochemical analyses indicated no specific abnormalities except mildly elevated C-reactive protein levels (1.89 mg/dL, normal range <0.14 mg/dL). Serum tumor marker levels, including carcinoembryonic antigen and carbohydrate antigen 19-9, were within the normal ranges. Although Helicobacter pylori infection was detected via serum antibody test, he had not received eradication therapy previously. Contrast-enhanced computed tomography (CT) showed circumferential gastric wall thickening with hyperenhancement on the mucosal surface, accompanied by infrapyloric lymphadenopathies (Figure A). Minimal ascites was found around the liver and in the pelvis. On fluorodeoxyglucose (FDG) positron emission tomography–CT, the thickened gastric wall and swollen lymph nodes showed intense accumulation of FDG with a maximum standardized uptake value of 5.23 and 4.33, respectively (Figure B). Moreover, minor mucosal erosions and ulcerations on the gastric body and the antrum were observed during esophagogastroduodenoscopy (EGD) (Figure C). The distensibility of the gastric wall by CO2 insufflation was not impaired on EGD. Endoscopic mucosal biopsies were performed on the thickened gastric wall with ulcerations. What is the most likely diagnosis here, and how should these lesions be treated? Look on page 339 for the answer and see the Gastroenterology website (www.gastrojournal.org) for more information on submitting to Gastro Curbside Consult. Gastric linitis plastica (GLP), a distinct subtype of gastric cancer characterized by thickening and rigidity of the gastric wall,1Vivier-Chicoteau J. Lambert J. Coriat R. et al.Development and internal validation of a diagnostic score for gastric linitis plastica.Gastric Cancer. 2020; 23: 639-647Crossref PubMed Scopus (10) Google Scholar was primarily suspected from the imaging findings. Perigastric lymphadenopathies and ascites suggested lymph node metastases and peritoneal dissemination, reflecting the aggressive behavior of GLP.1Vivier-Chicoteau J. Lambert J. Coriat R. et al.Development and internal validation of a diagnostic score for gastric linitis plastica.Gastric Cancer. 2020; 23: 639-647Crossref PubMed Scopus (10) Google Scholar However, the biopsy obtained from the margins of the ulceration did not reveal any malignant cells suggestive of GLP. Hematoxylin and eosin (HE) staining showed infiltration of numerous histiocytes and noncaseating granuloma formation (Figure D). Because the superficial biopsy often results in inconclusive diagnosis of GLP, laparoscopic resection of the swollen infrapyloric lymph nodes was performed to obtain a more substantial amount of tissue. HE staining of the surgically resected lymph nodes showed the formation of multiple small-size epithelioid granulomas (Figure E). To determine the etiology of granuloma formation, various kinds of immunohistochemical studies were performed. Accumulation of H pylori was observed inside the granuloma of both gastric mucosa (Figure F) and lymph nodes (Figure G) with the use of H pylori–specific antibody (B0471; Dako, Denmark) whereas Epstein-Barr virus or tuberculosis was not detected by in situ hybridization or Ziehl-Neelsen staining. In addition, the possibility of gastric sarcoidosis was low because the serum angiotensin-converting enzyme level was not elevated and gastric granuloma was negative for immunostaining of monoclonal antibody against Propionibacterium acnes (D371-3; MBL, Japan).2Yamaguchi T. Costabel U. McDowell A. et al.Immunohistochemical detection of potential microbial antigens in granulomas in the diagnosis of sarcoidosis.J Clin Med. 2021; 10: 983Crossref PubMed Scopus (17) Google Scholar,3Inomata M. Ikushima S. Awano N. et al.Upper gastrointestinal sarcoidosis: report of three cases.Intern Med. 2012; 51: 1689-1694Crossref PubMed Scopus (16) Google Scholar Therefore, the diagnosis of granulomatous gastritis associated with H pylori infection was made. Successful H pylori eradication therapy with vonoprazan, amoxicillin, and clarithromycin improved his symptoms. Furthermore, gastric wall thickening on CT as well as gastric mucosal ulcerations on EGD disappeared entirely 6 months after the H pylori eradication (Figures H and I), which further verified the diagnosis. This case highlights that granulomatous gastritis associated with H pylori infection needs to be considered in the differential diagnosis when encountering H pylori–positive cases exhibiting circumferential gastric wall thickening with lymphadenopathy.

Evaluation of effects of white vinegar- induced gastric mucosal ulceration in rats

This study was aimed to investigate the effects of white vinegar (WV) induced gastric mucosal ulceration in rats. Thirty rats were divided into three groups, group (1) was given distilled water as control group, group (2) was given WV with a dose [1 ml/kg (5%)] and group (3) was given WV with a dose [1 ml/kg (10%)] for 14 days. Results presented a significant decrease in the body weights and pH value of the gastric juice whereas, a significant increase occurred in gastric acid volume levels, total acidity, ulcer index and an ulcer score of stomach. Measurement of ulcer area of stomach showed, sever haemorrhagic areas covered with coagulated blood in group (3) while, group (2) showed, some spot ulcer and slight of haemorrhagic streaks compared with normal control group. The results of this study reveal that white vinegar has an effect on gastric mucosa from injury and ulcers in rats.

HISTOPATHOLOGICAL BASES OF ORGANIC DYSPEPSIA IN BENIN CITY – A HOSPITAL BASED STUDY OF 186 CASES

Dyspepsia is a symptom complex characterized by features which include epigastric pain or discomfort, belching, bloating and heart burn amongst others, and is one of the commonest indications for upper gastrointestinal endoscopy in Nigeria. The aim of this study was to determine the histopathological bases of organic dyspepsia in this environment. Upper gastrointestinal endoscopy specimens from 186 patients diagnosed with organic dyspepsia in our centre over the 6-month study period were the materials for the study. These were subjected to tissue processing and histopathological examination. The vast majority of the cases of organic dyspepsia had their histopathological bases in the stomach, mostly from various forms of chronic and reactive gastritis, with occasional cases of gastric mucosal ulcers and frank malignancies. Helicobacter pylori-associated chronic gastritis continues to underlie most organic causes of dyspepsia in our environment.

Zinc Acetate Dihydrate Tablet-associated Gastric Lesions

Objective This study aimed to determine the prevalence and endoscopic features of zinc acetate dihydrate tablet-associated gastric lesions. Methods We retrospectively examined the endoscopic features of 47 patients taking zinc acetate dihydrate tablets who underwent esophagogastroduodenoscopy. Results Gastric mucosal alterations, including redness, erosions, ulcers, and adhesion of the white coat, were observed in 29 of 47 patients (61.7%). Among patients with gastric lesions (group A), there was a significantly higher percentage of symptomatic patients in comparison to patients without lesions (group B) (65.5% vs. 22.2%; p<0.01). The background characteristics of the two groups did not differ to a statistically significant extent. On esophagogastroduodenoscopy, mucosal redness (n=27, 93.1%), erosions (n=26, 90.0%), adhesion of the white coat (n=25, 86.2%), and ulcers (n=9, 31.0%) were observed. None of the 19 patients who previously underwent esophagogastroduodenoscopy had gastric lesions before starting zinc acetate dihydrate. Esophagogastroduodenoscopy was performed after the cessation of zinc acetate dihydrate intake in six patients, and revealed the resolution of gastric lesions. Conclusion Gastric lesions were observed in 29 of 47 patients who were taking zinc acetate dihydrate tablets. The most common endoscopic findings were mucosal redness (93.1%), erosions (90.0%), adhesion of the white coat (86.2%), and ulcers (31.0%). Although the exact pathogenesis is uncertain, we believe that understanding the unique manifestations of this gastric lesion will help physicians manage adverse events in patients taking zinc acetate dihydrate tablets.

Therapeutic Effects of Vitamin E in Gastric Stress Ulcers and Obesity in Rats

Stress – related disturbances are classified among the health problems that have global interest, especially which are related to gastrointestinal system. The consequent oxidative stress is confirmed to be responsible for the development of gastric mucosal ulcers and necrosis. That is accompanied with the release of different inflammatory mediators. On the other hand, the ratio of obesity is gradually increasing in the world. It impairs the quality of life because of its associated serious complications. Vitamin E is a fat-soluble, free radicals scavenger antioxidant. It has anti-inflammatory and cell membrane-stabilizing properties. Besides, it has anti – obesity effects. The present study highlights the potential therapeutic effects of vitamin E in the treatment of stress-induced gastric ulcers in rats. Stomach injury was induced in fasted rats by cold- restraint stress (CRS) method. Vitamin E was administered orally at a dose of 100 mg/kg for 7 consecutive days. Rats were sacrificed on the 8th day. Assessment of the stomach injury was by studying body weight changes, macroscopic examinations, histological study, and determination of oxidative stress markers (MDA stomach content and SOD enzyme activity). Vitamin E administration alleviated the stomach injury degree, and caused a remarkable body weight decrease, with a statistical significance in comparison with the stressed group. Vitamin exerted good effects in reducing body weight, and healing of stress-induced gastric ulcers in rats.

Tricholoma matsutake-Derived Peptides Show Gastroprotective Effects against Ethanol-Induced Acute Gastric Injury.

Acute gastric injury caused by ethanol is a frequent disorder of the gastrointestinal tract. In this study, we investigated the potential gastroprotective effects of Tricholoma matsutake-derived peptides against ethanol-triggered acute gastric injury and the associated mechanisms. Peptides SDLKHFPF and SDIKHFPF significantly attenuated the ethanol-induced decrease in GES-1 cell survival (82.39 ± 1.93 and 80.10 ± 1.08% vs 56.58 ± 1.86%), inhibited GES-1 cell apoptosis, and alleviated the ethanol-induced gastric mucosal injury (64.76 ± 3.98 and 49.29 ± 3.25%), ulcer index (3.33 ± 0.47 and 4.67 ± 0.47 vs 6.67 ± 0.47), and histopathological changes in mice. Peptide treatment inhibited the phosphorylation and nuclear translocation of nuclear factor kappa B (NF-κB), the secretion of tumor necrosis factor-α, interleukin-6, and endothelin-1. In addition, T. matsutake peptide pretreatment increased growth factor secretion, upregulated B-cell lymphoma-2, downregulated Bcl-2-associated X (Bax), and cleaved cysteinyl aspartate specific proteinase 3, thereby promoting gastric cell survival. These findings strongly suggest that T. matsutake peptides attenuate ethanol-induced inflammatory responses and apoptosis by suppressing NF-κB signaling activation, thereby enhancing gastric epithelial barrier functions.

EP.FRI.988Life threatening recurrent bleeding gastric fundus Dieulafoy lesion: A case report

Abstract Introduction Dieulafoy lesion is a rare but significant cause of upper gastrointestinal tract (GIT) bleeding. Over 75% of Dieulafoy lesions are located in the stomach and they tend to be responsible for recurrent upper GIT bleeding. Endoscopic therapy is the first line intervention to achieve haemostasis. Patient A 49-year old normally fit man known to have a gastric Dieulafoy lesion since 2008 presented with a history of collapse on the street and significant melaena. He was tachycardic, with a heart rate of 116, and hypotensive, blood pressure 109/68 mmHg on admission. He had significant upper GIT bleeding from the gastric fundus Dieulafoy lesion in April 2008, requiring a massive blood transfusion. At the time, the attempted endoscopic therapy was unsuccessful, resulting in an emergency surgery and under-running of the bleeding vessels. For the recent admission, he underwent an urgent therapeutic oesophagogastroduodenoscopy, with 3 endoscopic clips applied, but this failed to maintain haemostasis. Four units of packed red cell were transfused and he was transferred immediately to the operating theatre. He underwent an emergency laparotomy, adhesiolysis, gastrostomy and wedge resection of the bleeding gastric fundus Dieulafoy lesion using a linear cutter 75mm stapler. He had an uneventful post-operative recovery and was discharged home on day four after surgery. The histology of the wedged gastric specimen confirmed an area of gastric mucosa ulceration with a network of mixed dilated, thin and thick-walled tortuous vessels in the adjacent submucosal layer. The histologic features are consistent with a bleeding gastric Dieulafoy lesion.

Gastroprotective effects of extract of Jasminum grandiflorum L. flower in HCl/EtOH-induced gastric mucosal ulceration mice

Jasminum grandiflorum L. is a medicinal plant used to treat hepatitis and gastritis, but the mechanisms underlying its protective effects against gastrointestinal mucosal damage remain to be elucidated. In this study, we analyzed the effects of four different extracts and two compounds from the flower of J. grandiflorum in a mouse model of HCl/EtOH-induced gastric ulcer. The flower extracts alleviated gastric mucosal ulceration by increasing PGE2 production and the activity of antioxidant enzymes, along with the suppression of reactive oxygen species (ROS) generation, lipid peroxidation, apoptosis-related proteins, pro-inflammatory cytokines and nitric oxide (NO) production.