Gastric Ulcer Pain Research Articles

Formulation and evaluation of capsules containing extracts of Cassia sieberiana for improved therapeutic outcome

In Ghana, the encapsulated blend of the powdered stem and root bark of Cassia sieberiana is prescribed and dispensed to patients at the Centre for Plant Medicine Research (CPMR), for the management of dysmenorrhea and gastric ulcer pain. This current formulation has significant challenges in manufacturing and optimization of therapeutic outcomes due to lack of standardization of actual quantities of the extracts obtained from ingestion of the product. The study sought to formulate and evaluate capsules of Cassia sieberiana using the stem and root bark. Extraction was undertaken with different solvents: absolute ethanol (F1) and 70% ethanol (F2). These 2 formulations were compared to the existing product (MP1) by CPMR. Granules for encapsulation were prepared by wet granulation and their flow properties compared with MP1. Drug-excipient compatibility was studied using FT-IR, TLC and UV. Quality control tests on MP1, F1 and F2 capsules were conducted using pharmacopoieal methods. From the results obtained, organoleptic and physicochemical properties of the extracts demonstrated its suitability for use in oral capsule formulation. MP1, F1 and F2 recorded a λmax of 278 nm, 278 nm and 276 nm, respectively. The extract per dose of capsules was found to be 27.84 ± 0.11 mg and 36.65 ± 0.03 mg for F1 and F2, respectively. Granules of F1 and F2 had good flow properties whereas MP1 demonstrated a fair flow property. FT-IR spectra showed possible interaction between extracts and excipients. However, TLC results indicated similar compounds present in the extracts and granules. The UV marker analysis also indicated no interaction since the percentage drug contents in F1 and F2 capsules were found to be 98.0% ± 1.40 and 98.90% ± 2.80 respectively. All 3 formulations passed the disintegration and uniformity of weight tests except MP1 which failed the latter. F1 capsules recorded the highest dissolution efficiency (99%) while MP1 recorded the lowest (22%). There was significant difference (p < 0.0001) in the release of Cassia sieberiana among the three formulations. This study has demonstrated the potential replacement of Cassia sieberiana capsules on the market with capsules developed from its extract with F1 capsules being the most desirable.

Chronic upper abdominal pain: site and radiation in various structural and functional disorders and the effect of various foods.

Pain site and radiation and the effect of various foods were studied prospectively in a consecutive series of patients with chronic upper abdominal pain. Patients followed for less than one year were excluded unless peptic ulcer or abdominal malignancy had been diagnosed or laparotomy had been carried out. A total of 632 patients were eligible for the first study and 431 for the second. Gastric ulcer pain was more likely to be left hypochondrial (17%) compared with pain from duodenal ulcer (4%) or from all other conditions (5%). It was less likely to be epigastric (54%) compared with duodenal ulcer pain (75%). Oesophageal pain was more likely to be both retrosternal and epigastric (25%) compared with non-oesophageal pain (2%). Radiation to the back was more common in peptic ulcer (31%) and biliary pain (35%) compared with functional pain (20%). Pain precipitation by fatty foods was commoner in biliary disease (40%) than in duodenal ulcer (11%), peptic ulcer (9%), or non-ulcer dyspepsia (19%). Orange, alcohol, and coffee precipitated pain more frequently in duodenal ulcer (41%, 50%, and 43% respectively) than in biliary disease (17%, 0%, and 14% respectively). Chilli precipitated pain in one quarter to one half of subjects regardless of diagnosis. Approximately one tenth of all subjects avoided chilli, curry, coffee, and tea because of medical or other advice.

Acid and Gastric Ulcer Pain

We have shown previously that acid is one factor, although not the only one, in the pathogenesis of duodenal ulcer pain. In the present study patients with gastric ulcer were endoscoped without sedation or premedication. Under direct vision the ulcer craters were infused sequentially with 0.1 N HCl and normal saline, the sequence of infusion being randomized and double blind. Typical ulcer pain occurred in seven of 19 patients during acid infusion compared with one with saline (p = 0.023). Two patients who developed pain on acid were rechallenged after their pain disappeared, and typical pain recurred in both. Acid therefore has a definite role in the pathogenesis of gastric ulcer pain.

Studies on the Mechanism of the Pain of Peptic Ulcer

Article1 July 1931Studies on the Mechanism of the Pain of Peptic UlcerFRED M. SMITH, M.D., F.A.C.P., W. D. PAUL, M.D.FRED M. SMITH, M.D., F.A.C.P.Search for more papers by this author, W. D. PAUL, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-5-1-14 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptVarious explanations have been given for the pain of peptic ulcer. In general, however, there are two prevailing conceptions. One is primarily concerned with the irritating action of the hydrochloric acid of the gastric juice on the exposed nerve endings in the ulcer. The other places the emphasis on the altered motor function as represented by spasm, particularly of the pylorus or pyloric sphincter, hyperperistalsis or a combination of these factors producing increased gastric tension.Talma1was one of the first to study the mechanism of gastric pain by the introduction of acid into the stomach. Bönninger,2Heinecke and von...References1 TALMA S: Zur Behandlung von Magenkrankheiten, Zeit. f. klin. Med., 1884, VIII, 407. Google Scholar2 BÖNNIGER M: Zur Diagnose des Ulcus Ventriculi, Berl. klin. Wchnschr., 1908, XLV, 396. Google Scholar3 HEINEKEVAN SELMS DM: De la sensibilité de l'estomac, Arch. des Mal. de l'Appar. dig., 1908, II, 467. Google Scholar4 SIPPY BW: Oxford Medicine, New York, Oxford Univ. Press, Vol. 3, Page 132. Google Scholar5 PALMER WL: The mechanism of pain in gastric and duodenal ulcer; production of pain by means of chemical irritants, Arch. Int. Med., 1926, XXXVIII, 694. CrossrefGoogle Scholar6 HURST AF: The sensibility of the alimentary canal, London, 1911. Google Scholar7 HURSTSTEWART AFMJ: Gastric and duodenal ulcer, New York, Oxford Univ. Press, 1929. Google Scholar8 RYLE JA: A clinical study of pain: with special reference to the pains of visceral disease, Brit. Med. Jour., 1928, I, 537. CrossrefGoogle Scholar9 CARLSON AJ: The control of hunger in health and disease, Chicago, 1906. Google Scholar10 GINSBURGTUMPOWSKYHAMBURGER HIWW: Newer interpretation of the gastric pain in chronic ulcer, J. A. M. A., 1916, LXVII, 990. CrossrefGoogle Scholar11 CARLSON AJ: Contributions to the physiology of the stomach, XLIV. The origin of the epigastric pains in cases of gastric and duodenal ulcer, Amer. Jour. Physiol., 1917, XLV, 81. CrossrefGoogle Scholar12 HARDT LL: Pain in active pathologic processes in stomach or duodenum; gastric and duodenal contractions as the direct cause. J. A. M. A., 1918, LXX, 837. CrossrefGoogle Scholar13 HARDT LL: Studies of the cause of pain in gastric and duodenal ulcers; peristalsis as direct cause of pain in gastric ulcers with achylia and in duodenal ulcers, Arch. Int. Med., 1922, XXIX, 684. CrossrefGoogle Scholar14 ORTMAYER M: Gastric motor activity in patients with peptic ulcer, Arch. Int. Med., 1925, XXXV, 423. CrossrefGoogle Scholar15 HOMANS J: The relation of pain in gastric and duodenal ulcer to muscular activity of the stomach, Amer. Jour. Med. Sci., 1919, CLVII, 74. CrossrefGoogle Scholar16 POULTON EP: An investigation of the cause and relief of pain in gastric ulcer, Lancet, 1921, CC, 263. CrossrefGoogle Scholar17 MACLEOD D: A note on pain in relation to duodenal ulcer, Lancet, 1929, CCXVII, 1358. CrossrefGoogle Scholar18 POULTON EP: On an experimental study of certain visceral sensations, Lancet, 1928, CCXV, 1223. Google Scholar19 REYNOLDSMCCLURE LCW: Motor phenomena occurring in normal stomachs, in presence of peptic ulcer and its pain, as observed fluoroscopically, Arch. Int. Med., 1922, XXIX, 1. CrossrefGoogle Scholar20 WILSONMALCOLM J: Duodenal ulcer: Observations on the behavior of stomach and duodenum in the presence of pain, Arch. Int. Med. 1928, XLI, 633. CrossrefGoogle Scholar21 SMITHPAULFOWLER FMWDWM: The mechanism of the epigastric distress associated with an irritable colon and chronic appendicitis, Arch. Int. Med. 1931, XLVII, 316. CrossrefGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Iowa City, Iowa*From the Department of Internal Medicine, State University of Iowa.†Delivered at the Baltimore Meeting of The American College of Physicians, March 23, 1931. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byPain in peptic ulcerMechanism of Pain in Peptic UlcerGrundlagen der gastrographischen MethodikThe value of a special pepsin-pancreatic preparation in the treatment of peptic ulcer and gastric hyperacidityPeptic Ulcer 1 July 1931Volume 5, Issue 1Page: 14-22KeywordsGastric ulcersHydrochloric acidNerve endingsPeptic ulcersStomach ePublished: 1 December 2008 Issue Published: 1 July 1931 PDF downloadLoading ...