Incidence Of Gastric Ulcers Research Articles

<i> Helicobacter pylori</i> Infection and Non-steroidal Anti-inflammatory Drugs Mediated Gastric Ulcer: Insights into Efficacy and Strategies for Gastroprotective Treatments and Disease Management

Context: Helicobacter pylori infection and the use of non-steroidal anti-inflammatory drugs (NSAIDs) are the primary etiological factors contributing to gastric ulcer disease, characterized by mucosal erosions in the stomach. This condition remains a significant global health challenge, particularly in low- and middle-income countries, where it substantially contributes to morbidity and premature mortality. Complications such as gastrointestinal bleeding and perforation exacerbate the disease burden, underscoring the need for effective preventive and therapeutic strategies. Objectives: To evaluate the effectiveness of proton pump inhibitors, prostaglandin analogues, and histamine-2 (H2) receptor antagonists in preventing and healing gastric ulcers caused by H. pylori and NSAID use. The study aims to identify optimal treatments and explore patient-specific responses for improved, personalized therapy. Methods: This systematic review and meta-analysis evaluated the efficacy of gastroprotective treatments, including proton pump inhibitors (PPIs), prostaglandin analogues, and histamine-2 receptor antagonists (H2RAs), in preventing and healing gastric ulcers. A comprehensive search was conducted across PubMed, Embase, and the Cochrane Library. Inclusion criteria focused on Randomized Controlled Trials (RCTs) assessing these treatments in patients with gastric ulcers. Quality assessment was performed using the adapted Newcastle–Ottawa Scale. The DerSimonian and Laird random-effects model was employed to determine pooled effect sizes, with heterogeneity assessed using Cochran’s Q and I² statistics. All analyses were conducted using Stata/MP 17.0. Results: The search identified 2,687 records, with 116 studies meeting the inclusion criteria after rigorous screening and quality assessment. The meta-analysis included studies on PPIs, prostaglandin analogues, and H2RAs, involving 18,042 participants in the treatment groups and 13,255 in the control groups. PPIs significantly reduced the incidence of gastric ulcers (log odds ratio = -1.17, 95% CI: -1.97 to -0.37, P < 0.001) with high heterogeneity (I² = 98.13%). Prostaglandin analogues (log odds ratio = -1.61, 95% CI: -2.49 to -0.73, P < 0.001) and H2RAs (log odds ratio = -0.86, 95% CI: -1.92 to 0.20, P < 0.001) also demonstrated significant protective effects despite high heterogeneity. Conclusions: Gastroprotective treatments, particularly PPIs and prostaglandin analogues, are effective in reducing gastric ulcer incidence. The high heterogeneity among studies suggests the need for individualized treatment approaches. Further research is warranted to refine protocols and optimize patient-specific therapies.

Gastroprotective activity of Banana peel (Musa paradisiaca var. sapientum) methanol extract purified on aspirin-induced gastric ulceration in Rats

Banana (Musa paradiasiaca var. sapientum) is the world's most popular fruit-bearing crop, with rising consumption and waste. This study aimed to measure the metabolite compound and evaluate the gastroprotective properties of a banana peel-purified methanol extract. Animals test used in this study were divided into six groups: Group One received NaCMC 0.5%, Group Two received sucralfate, Group Three received aspirin 1000 mg/kg body weight, and groups four, five, and six received PBP at doses of 200 mg/kg body weight, 400 mg/kg body weight, and 600 mg/kg body weight, respectively, for seven days. Except for group 1, all groups were induced with aspirin at 1000 mg/kg body weight on the eighth day. The result of this study exhibited banana peel containing total phenolic, flavonoid, and tannin compounds with concentrations of 33.45 mg GAE/g, 19.92 mg QE/g, and 0.16 %, respectively. The results showed that pure extract of Musa paradiasiaca var. sapientum fruit peel can reduce the incidence of gastric ulcers by decreasing the ulcer index (p<0.05).. The results suggested that Musa paradisiaca var. sapientum peel has a gastroprotective effect against aspirin-induced gastric ulceration.

Assessment of the Additive Effect of Oral Streptomycin with Traditional Regimen Therapy to Eradicate H-Pylori

Recently, an increased incidence of gastrointestinal disorders due to the overgrowth of H. pylori bacteria has been noticed remarkably. One of the clinical manifestations of H. pylori overgrowth is the increased incidence of gastric ulcers. The first line of therapy that is used frequently is triple antibiotic therapy plus gastric reducing agents, notably proton pump inhibitors (P.P.Is). Streptomycin (SM) is an injectable aminoglycoside antibiotic that has enhanced activity on gran-negative microbes. To evaluate the additive effect of SM when used orally on eradicating H. pylori by standard triple therapy. 109 patients were enrolled in this study with a gastroenterologist diagnosed with gastric ulcer caused by H. pylori colonization; 60 patients received triple therapy with oral SM, and the rest received only standard triple therapy. After 14 days of treatment, a urea breath test was done again (after baseline reading), and statistical analysis was performed to evaluate the effect of SM. The Results showed that there was a significant difference in the degree of response to triple therapy plus SM as compared to using triple therapy alone.

Gastroprotective mechanism of Talinum triangulare on ethanol-induced gastric ulcer in Wistar rats via inflammatory, antioxidant, and H+/K+-ATPase inhibition-mediated pathways

The increase in the incidence of gastric ulcer (GU) has posed major threat on public health. This research aimed to evaluate gastroprotective properties of the aqueous leaf extract of Talium triangulare (AETT) in ethanol-induced gastric ulceration. GU was induced via oral administration of single dose of 5 mLkg−1 of 90% ethanol in rats and protection of 200 mgkg−1 bw of AETT and 20 mgkg−1 bw of omeprazole was investigated for 14 d via oral treatment. Influence of AETT on anti-inflammatory, redox assays, ulcer index (UI), and gastric mucosa histological alterations were evaluated. Significant increase in myeloperoxidase (MPO) and tumor necrosis factor-alpha levels compared to untreated group established gastric inflammation in rats induced by ethanol. Gastric ulcerated group exhibited heightened oxidative stress with concurrent decline in activities of antioxidant enzymes. Ethanol exposure to rats resulted in induction of lipid peroxidation, prominently elevating gastric malondialdehyde (MDA) concentration. Nevertheless, treatment with AETT or omeprazole exhibited substantial anti-inflammatory effects within gastric mucosa by attenuating expression of markers associated with inflammation. AETT demonstrated reduction in concentrations of MDA and H2O2, thereby alleviating progression of lipid peroxidation cascades. Also, AETT exhibited mitigating effect on ethanol-induced oxidative harm by enhancing the functionality of protective enzymes and elevating glutathione (GSH) concentration. Overall, AETT exhibited enhancements in activities of cytoprotective antioxidant enzymes, mitigated impact of oxidative stress and inflammation, inhibited lipid peroxidation, and decreased UI score. These beneficial effects could be attributed to phytochemicals present in AETT including 6,10,14-trimethyl-2-pentadecanone and Phytol. Outcome of this study established the traditional herbal claims of AETT.

Albizzia chinensis (Osbeck) Merr extract YS ameliorates ethanol-induced acute gastric ulcer injury in rats by regulating NRF2 signaling pathway.

Around the world, there is a high incidence of gastric ulcers. YS, an extract from the Chinese herb Albizzia chinensis (Osbeck) Merr, has potential therapeutic applications for gastrointestinal diseases. Here we elucidated the protective effect and underlying mechanism of action of YS on gastric ulcer in rats injured by ethanol. The ethanol-induced gastric ulcer rat model was used to assess the protective effect of YS. A pathological examination of gastric tissue was performed by H&E staining. GES-1 cells damaged by hydrogen peroxide were used to simulate oxidative damage in gastric mucosal epithelial cells. Endogenous NRF2 was knocked down using small interfering RNA. Immunoprecipitation was used to detect ubiquitination of NRF2. Co-immunoprecipitation was used to detect the NRF2-Keap1 interaction. YS (10 and 30 mg/kg, i.g.) significantly reduced the ulcer index, decreased MDA level, and increased SOD and GSH levels in gastric tissues damaged by ethanol. YS promoted NRF2 translocation from cytoplasm to nucleus and enhanced the NQO1 and HO-1 expression levels in injured rat gastric tissue. In addition, YS regulated NQO1 and HO-1 via NRF2 in H2O2-induced oxidative injured GES-1 cells. Further studies on the underlying mechanism indicated that YS reduced the interaction between NRF2 and Keap1 and decreased ubiquitylation of NRF2, thereby increasing its stability and expression of downstream factors. NRF2 knockdown abolished the effect of YS on MDA and SOD in GES-1 cells treated with H2O2. YS reduced the NRF2-Keap1 interaction, promoting NRF2 translocation into the nucleus, which increasing the transcription and translation of NQO1 and HO-1 and improved the antioxidant capacity of rat stomach.

Effect of celery (Apium graveolens l) ethanol extract on the prevention of gastric ulcers in rats

Background: Gastric ulcer is an excoriation area of the stomach caused by the destruction of mucosal defense against the predominant factors. One of the efforts that should be made to reduce the incidence of gastric ulcers is a precautionary measure to use ethanol extract of celery (Apium graveolens L). Celery contains phenolic compounds, such as apigenin which acts as an antioxidant. Antioxidant has the potential as an agent of gastric mucosal protection against cell damage caused by excessive activation of free radicals (ROS). Objectives: This study aimed to determine the effect of celery ethanol extract in preventing gastric ulcers through a reduction of ulcer lesion length. Method: Research method Post-test Only Randomized Controlled Group Design conducted on Wistar strain rats. Experimental animals were divided into 5 groups: healthy, normal wound with induction indomethacin, and celery ethanol extract administered orally at a dose of 200 mg/kg, 300, mg/kg, and 400 mg/kg. Observations were made on the length of gastric ulcer lesions. The length of the gastric ulcer was measured using a vernier caliper and statistically analyzed by the One-way ANOVA test. Result: The result showed that the ethanol extract of celery at 300mg/kgBB was the best dose in preventing the formation of gastric ulcer by decreasing the length of the gastric ulcer. Conclusion: Based on these results, the researcher suggests comparing other various parameters regarding the effect of celery ethanol extract for the prevention of gastric ulcers.

24 Intestinal Function and Integrity in Health and Disease: Current Knowledge in Swine

Abstract Optimal lean tissue accretion is contingent on the ability of the pig to efficiently establish and maintain host defenses, and to digest and absorb nutrients and water. Epithelial cells in the mucosa of the gastrointestinal tract interconnect with each other by tight junctions, adherens junctions, and desmosomes, forming a complete intestinal barrier. Of the secretory cells in this epithelial barrier, mucus secreting goblet cells and hormone producing enteroendocrine cells can be found interspersed, while Paneth cells lie in the base of the crypts and secrete antimicrobial proteins/peptides into the mucus layer. In the small intestine, enterocytes lining the villi allow for efficient nutrient transport. Maintenance of the epithelial barrier and its function is dependent on intestinal stem cells residing at the crypt base. Two major signaling pathways controlling intestinal stem cell proliferation and differentiation are the β-catenin/Wnt and Notch signaling pathways. Thus, achieving and maintaining optimal nutrient absorptive capacity requires an intricate balance amongst β-catenin/Wnt and Notch signaling pathways, wherein dysregulation of either can result in inefficiency of nutrient absorption. Weaning transition, off-feed events, hypophagia, and enteric and respiratory diseases can all compromise the structural and secretory barrier of the gastrointestinal tract mucosa via changes in tight and adherens junction proteins and mucin production. As a result, these stressors can increase the incidence of gastric ulcers, villous atrophy, and colitis in pigs. Depending on the severity and duration of the mucosal damage, repair and restitution occurs due to increased stem cell proliferation, migration, and repolarization. Thus, efficiency of digestive and absorptive function depends on several factors, including the types of epithelial cells present and their functionality, the rate of cell renewal, and epithelial surface area. This paper will discuss what we know about the regulation and repair of the mucosal epithelium in growing pigs during health, stress, and disease.

A231 THE FLAVANOID CYANIDIN REDUCES INTESTINAL INFLAMMATORY DAMAGE BY MAINTAINING INTESTINAL PERMEABILITY

Abstract Background Since the discovery and the use of proton pump inhibitors (PPI), the incidence of gastric ulcers has reduced, however, there has been an increase in intestinal lesions since PPIs do not guarantee protection to the intestine. To protect the deeper layers of the intestinal wall, the intestinal barrier tightly regulates the passage of pro-inflammatory molecules, microorganisms, toxins, and antigens. The epithelium is damaged during intestinal inflammation due to the action of inflammatory cytokines such as TNF resulting in ulceration. Cyanidin is a flavonoid of the anthocyanin class, found in several red fruits, with anti-inflammatory and antioxidant activity. Purpose We hypothesized that the administration of cyanidin can decrease the deleterious effects caused by polypharmacy (PPI + NSAID) in the small intestine by reducing intestinal permeability. Method In vivo: Male mice (8 weeks old) were treated to induce intestinal ulcers caused by polypharmacy (combination of PPI - lansoprazole 20 mg/kg daily, non-steroidal anti-inflammatory drug (NSAID) - acetylsalicylic acid 10 mg/kg daily and COX-2 selective NSAID, celecoxib 20 mg/kg daily). On the ninth day, oral treatment with cyanidin (5 mg/kg) or vehicle was started until the fourteenth day, then the animals were killed for parameter analysis lesion. ELISA was performed to quantify interleukins (IL-10, IL-6, IL-1β) and cytokine (TNF), and we assessed the antioxidant profile (SOD, CAT, and GSH) and measured gene expression of TNF, IL-10, IL-6 TRL-4, HMOX-1, MMP 2 and 9, COX-1, MUC-3, ZO-1, CL-1. In vitro: Monolayers of colonic epithelial cell lines (Caco-2 at 21 days of confluence) were mounted in Ussing chambers to assess barrier function and to determine transepithelial resistance (TER). To analyze the permeability response to injury, we utilized TNF and IFN (25 ng/mL) with cyanidin (10 or 100 uM) for 48 h in transwell plates, with measurement of total intestinal permeability using 4 kD FITC-dextran. Result(s) Analysis of mouse intestine indicated that cyanidin (5 mg/kg) significantly reduced expression of IL-6 and TNF, TLR4, and HMOX-1 (p<0.05), and increased gene expression of MUC-3, CL-1, occludin, COX-1, and IL-10 (p<0.05) without altering antioxidant parameters. Cyanidin (100 mM) maintained barrier function as shown by transepithelial electrical resistance (TER), and also significantly reversed the detrimental effects of the inflammatory cytokine on FITC-dextran flux in Caco-2 cells (p<0.05). This may be related to the increased expression of occludin and ZO-1 in the intestinal epithelium of mice. Conclusion(s) These in vivo and in vitro results suggest that cyanidin decreases the polypharmacy-induced intestinal inflammatory response while maintaining the integrity of the intestinal epithelium. Other trials are underway to elucidate these mechanisms. Please acknowledge all funding agencies by checking the applicable boxes below Other Please indicate your source of funding; NSERC; FAPESP Disclosure of Interest None Declared

Comparison of Haematological Variables in Helicobacter Pylori-Infected Patients with Ulcer and without Ulcer: A Cross-sectional Study

Introduction: Helicobacter pylori (H. pylori) is predominantly responsible for acute and chronic progressive gastroduodenal inflammation. Symptoms of gastric diseases vary from dyspepsia to altered bowel movements, leading to ulcers and potential gastrointestinal bleeding. Consequently, H. pylori can have a variable effect on the gastrointestinal tract and other organs. Ongoing research has shown associations between H. pylori and haematological manifestations. Recent studies have reported a 90% incidence of duodenal ulcers and an 80% incidence of gastric ulcers in patients with H. pylori infection. Aim: To investigate haematological manifestations in H. pyloriinfected patients with and without ulcers, and to compare the haematological variables. Materials and Methods: This cross-sectional study was conducted in the Department of Gastroenterology at King George’s Medical University in Lucknow, India, from October 2021 to October 2022. One hundred patients diagnosed with H. pylori-positive biopsy through endoscopy were enrolled in the study. Among these patients, 51% had ulcers with H. pylori infection (enrolled as cases), while 49% were H. pylori infected but without ulcers (enrolled as controls). Samples were analysed for Haemoglobin (Hb) levels, Red Blood Cell (RBC) count, Reticulocyte Count (RetC), serum iron, serum ferritin, Total Iron Binding Capacity (TIBC), serum vitamin B12, and Homocysteine (HCy) levels. Statistical analysis involved independent sample t-tests to compare continuous data and chi-square tests to compare categorical data. Results: The majority of patients included in the study, both with ulcers (70.6%) and without ulcers (59.2%), were males with mean±Standard Deviation (SD) ages of 32.39±7.25 years and 29.86±7.66 years, respectively. In the present study, low reticulocyte count, anaemia, deranged RBC count, low serum iron, high TIBC, and low ferritin were observed in 9%, 22%, 61%, 11%, 12%, and 8% of the patients, respectively. Vitamin B12 deficiency and hyperhomocysteinemia were observed in 6% and 1% of the cases, respectively. Among patients with ulcers, the strongest correlation was found between serum iron and serum ferritin (r-value=0.901), while the weakest correlation was found between vitamin B12 and RetC (r-value=0.206). Among patients without ulcers, the strongest correlation was found between serum iron and Hb (r-value=0.884), while the weakest correlation was found between TIBC and HCy (r-value=0.270). Conclusion: The present study demonstrates a significant association between H. pylori infection-induced ulcers and decreased mean reticulocyte count, serum iron, and serum ferritin levels. Recognising these haematological derangements and including them as indications for H. pylori eradication may lead to a remarkable improvement in the management regime.

Efficiency and Mechanism Evaluation of Magnolia officinalis Water Extract in Preventing Gastric Ulcer.

In this study we aimed at demonstrating the ability of Magnolia officinalis water extract to ameliorate gastric ulcers in in vitro and in vivo experiments. The gastric mucosa epithelial cell line, RGM 1, was pretreated with Magnolia officinalis water extract (0, 0.1, 1, 2, 5, or 10 mg/ml) and cultured in DMEM/F12 medium (pH 7.4) for 2 h and then in DMEM/F12 medium (pH 4.0) for 10 min. Magnolia officinalis water extract protected the cell viability and decreased reactive oxygen species formation by the acidic medium. In the in vivo experiment, Magnolia officinalis water extract (100 mg/kg) was administrated daily for 28 days in ICR mice via oral gavage, and then Shay's ulcer surgical method was performed to induce gastric ulcers. We analyzed the pH value of stomach acid and the pathological section, inflammation, and cannabinoid receptor type 2 (CB2) cDNA levels of the stomach. Magnolia officinalis water extract not only enhanced the pH value of stomach acid but also ameliorated the ulcer index and inflammation and increased CB2 expression effectively. These results suggest that Magnolia officinalis water extract might be used to decrease the incidence of gastric ulcer.

Effect of moving from being extensively managed out in pasture into training on the incidence of equine gastric ulcer syndrome in Icelandic horses.

To investigate equine squamous gastric disease (ESGD) and equine glandular gastric disease (EGGD) in Icelandic horses moving from pasture into training. 81 horses (median age, 3 years; interquartile range, 1 year) from 10 farms representing 4 different Icelandic regions. Initial gastroscopy was undertaken within 2 weeks of moving from pasture into a training establishment. A total of 71 horses underwent endoscopic examination again 8 weeks later. Various management and behavioral factors were assessed through face-to-face questionnaires with the owners or trainers. Multivariable logistic regression was used to determine factors contributing to any change in ESGD and EGGD severity score during the 8-week training period. Incidence of EGGD and ESGD in this feral population was similar to that found in domesticated horses. ESGD incidence (severity score, ≥ 2; score range, 0 to 4) reduced from an initial 71.6% (58/81) to 25.4% (18/71). On multivariable analysis, sex (ie, being a stallion or a female vs gelding) increased the likelihood of ulcer grade reduction. Being fed preserved forage 3 or more times a day also improved the likelihood of ESGD reduction (odds ratio, 17.95; 95% CI, 1.67 to 193.40; P = .017). Overall, the farm explained 35% of the variance, confirming the importance of management factors. Incidence of EGGD (severity score, ≥ 1; score range, 0 to 2) reduced from 47% (38/81) to 40.8% (29/71) during the same period. No measured variables were associated significantly with EGGD incidence or reduction. Pasture provision (without supplementary feed or forage) does not result automatically in a low incidence of gastric ulcers. Regular provision of preserved forage is a key factor in reducing ESGD incidence.

A retrospective controlled study of TACE-HAIC-targeted-immune quadruple therapy for intermediate and advanced-stage hepatocellular carcinoma

Objective: To evaluate the efficacy and safety of transcatheter arterial chemoembolization (TACE)-hepatic arterial infusion chemotherapy (HAIC)-targeted-immune quadruple therapy in patients with intermediate and advanced-stage hepatocellular carcinoma (HCC). Methods: 101 patients with intermediate and advanced stage HCC were enrolled according to the inclusion and exclusion criteria, and then they were divided into a combination group and a control group. Patients in the combination group was treated with TACE-HAIC-targeted-immune quadruple therapy, while the control group was only treated with TACE therapy. The overall survival (OS), progression-free survival (PFS), and treatment-related adverse reactions were statistically analyzed in the two groups of patients. Statistical analysis was carried out by t-test, χ2 test, rank sum test, Kaplan-Meier curve, log-rank test, Cox regression (or proportional hazards model) analysis according to different data. Results: The tumor objective response rate and disease control rate as evaluated by mRECIST 1.1 criteria in the combination group were 80% and 94%, respectively, which were significantly higher than those in the control group, 41.2% (P<0.001) and 74.5% (P=0.007). The OS and PFS of the combination group were 15.6 months [95%CI 11.3-NA ] and 8.8 months [95%CI 6.9-12.0], respectively, which were significantly better than the control group at 6.1 months [95%CI 5.3-6.6] (P<0.001) and 3.2 months [95%CI 3.0-3.6] (P<0.001). Gastric ulcer incidence was significantly higher in the combination group (9/50, 18%) than that in the control group (2/51, 3.9%) (P=0.023). Conclusion TACE-HAIC-targeted-immune quadruple therapy is a more effective treatment mode for intermediate and advanced-stage HCC than TACE alone, and attention should be paid to the monitoring of target immune-related adverse reactions.

Gastric Ulcers in Alpacas- Clinical, Laboratory, and Pathological Findings.

Gastric ulcers are a common finding in post-mortem examinations of South American camelids (SAC), but diagnosis in living animals is often difficult. The aim of this study was to provide an overview of the incidence of gastric ulcers in alpacas, common concomitant diseases, and clinical as well as laboratory findings to facilitate diagnosis for veterinarians. For this purpose, a total of 187 necropsy reports of alpacas were evaluated, including clinical and laboratory findings on the living animal. A total of 23.5% of the animals (n = 44) were found to have gastric ulcers, nine were perforated. Compartment 3 was most frequently affected by gastric ulcers. No sex predilection could be detected, but animals 1 year of age and older were more frequently affected by gastric ulcers than animals under 1 year of age. Alpacas with gastric ulcers were presented to the clinic due to different non-specific symptoms. In alpacas with gastric ulcers, significantly more organs or organ systems besides the stomach revealed clinical findings than in animals without gastric ulcers. Of the 44 animals with gastric ulcers, a total of 21 alpacas (47.7%) had a poor nutritional status, but cachexia was not significantly more frequent in animals with gastric ulcers than in other dissected animals without ulcers. Hematologic investigations revealed a significantly lower white blood count and significantly lower segmented neutrophils than in deceased animals without ulcers. Compared to animals discharged after treatment, alpacas that died with gastric ulcers had significantly higher levels of band neutrophils and fewer eosinophils and basophils. Occult blood in feces was found in three of 12 animals with gastric ulcers examined for occult blood. In summary, gastric ulcers are a common problem in SAC, which is difficult to diagnose clinically or by laboratory investigations. As these are often chronic processes involving other organ systems, regular monitoring of the animals' nutritional status and early detection of disease symptoms may help to prevent gastric ulcers.

Effect of Heparin on the Formation and the Healing of Kissing Gastric Ulcers in Rats

The incidence of gastric ulcers remains at a fairly high level: it is diagnosed annually in 7‐14% of the adult population. Despite the decrease in morbidity and the development of diagnostic methods as well as effective treatment, the number of complications such as bleeding and perforation is increasing. One of the significant pathological factors leading to the gastric injury is disturbances in blood flow through mucosal microvessels (providing oxygen and nutrients). In this regard, it becomes relevant to study drugs that affect the rheological properties of blood and microcirculation.This study aimed to investigate the effect of heparin on the formation and the healing of the experimentally induced gastric ulcers in rat. Adult male Sprague‐Dawley rats weighing 230‐250 g were used after 24 h preliminary fasting. Gastric ulcers were produced by luminal application of 60% acetic acid to an area clamped with a pair of forceps (kissing ulcer model developed by S. Okabe) in anesthetized rats. Day 4 after the application (Day 0) was chosen as the time point for the ulcer formation, and Day 7 was chosen as the time point for incomplete ulcer healing. Heparin was injected at a dose of 1000 U/kg (s.c., once a day). While studying the effect on the ulcer formation, heparin was injected daily from Day 0 to Day 3. While studying the effect on the ulcer healing, heparin was injected daily from Day 4 to Day 6. Control rats were injected with saline. The blood hemoglobin levels were evaluated before the acid application surgery and in the end of experiments.The heparin injection before the ulcer formation resulted in a decrease of the ulcer area. The average area of kissing ulcers in heparin‐treated group was significantly smaller than that in the control group (p &lt;0.05). The ulcer healing was significantly accelerated in the heparin‐treated group in comparison to the control group (p &lt; 0.05). Blood hemoglobin levels were decreased in both heparin‐treated and control groups without significant differences between the groups.The results suggest that heparin therapy has the potential to accelerate gastric ulcer healing and prevent their formation.

Non-targeted metabolomics of saliva to explore potential biomarkers for gastric ulceration in pigs fed hemp

Gastric ulceration is a common disease in pig production worldwide and is associated with economic losses as well as animal health and welfare issues. The aim of this study was to explore potential salivary biomarkers for gastric ulceration in pigs. In addition, the aim was to study the effect of hemp on the incidence of gastric ulcers. Approximately 440 growing-finishing pigs in the period from 30 to 110 kg BW were allocated to four different diets: meal feed (Meal); pelleted feed (Pellets); pelleted feed added 4% hempseed cake (Hemp Cake); pelleted feed added 4% hempseed hulls (Hemp Hulls). The day before slaughter, saliva samples from each pig were collected. After slaughter, the stomachs were emptied to assess the consistency of the stomach content and examined for gastric ulceration using an index scale (0–10). Noticeable changes of the gastric mucosa (total index score ≥ 6) were observed in 291 pigs. The odds of having index scores 0–5 relative to index scores 6–8 and 9–10, respectively, were higher (P < 0.001) for pigs fed Meal compared to pigs fed Pellets. The odds of suffering from severe gastric ulcers tended (P = 0.08) to be lower in pigs fed Hemp Hulls compared to pigs fed Pellets. A non-targeted liquid chromatography mass spectrometry based metabolomics analysis was performed on saliva samples to determine any separation between pigs with healthy stomachs and those with gastric ulcers and to examine a possible correlation between gastric ulcer index and potential biomarkers. Partial least-squares discriminant analysis showed a separation between pigs with ulcers and those with healthy stomachs/hyperkeratosis (HK). Metabolites contributing to the separation between groups were identified. Levels of oxylipins deriving from linoleic acid were lower (P < 0.001) in pigs with ulcers compared to healthy/HK pigs. This may indicate a shift in the metabolic pathways towards more pro-inflammatory arachidonic acid-derived eicosanoids, which might reflect an increased inflammatory response. Thus, reduced levels of oxylipins derived from linoleic acid seemed to be associated with active gastric ulcers, and thereby they might function as biomarkers for gastric ulceration in pigs. In addition, supplementation of hempseed hulls had a beneficial effect on severe gastric ulcers, as hempseed hulls changed the consistency of the gastric content by conferring more solidness. However, it was not possible to observe any reliable separation between pigs fed pellets supplemented with hemp products and pigs fed non-supplemented pellets according to the identified salivary metabolites.

Manifestação de úlceras gástricas em equinos aplicados na segurança pública

ABSTRACT We evaluated 28 horses from a squad applied in public safety in Paraná (Brazil), in order to check the incidence of gastric ulcers and its correlation with mounted policing activity, considering the initial and maintenance training to which such animals are submitted. Horses were divided in two groups, one named control with 14 individuals, used in policing community activities, and the 14 others named as target group, these were used in restoration and maintenance of public order. Both groups have differentiated maintenance training protocols, and all had been evaluated for fecal occult blood, clinical evaluation, gastroscopy and histopathological. There were no significant changes that proved the development of gastric ulcers in horses used in public safety due to initial and maintenance training, and the main factor for prevention was the diversified diet with emphasis in hayed alfalfa.

A Review on Incidence of Gastric Ulcer and its Herbal Remedies

Gastric ulcer is basically an inflamed break in the mucus lining membrane on the gastrointestinal alimentary track. The most common causes of gastric ulcers include H. pylori and gastric prostaglandin loss associated with the use of NSAIDs medication. Gastric ulcer formation depends on the presence of pepsin and acid secretions in gastric juice which breakdown the mucosal defences. It may be caused due to excessive stress or irregular food habits. Many synthetic drugs are used for the treatment of ulcer but they may have certain side effects. On the other hand, herbal medicines are completely safe and beneficial for treating ulcers. This review brings to light that the major incidence of gastric ulcer varies worldwide and the complications thereof put a heavy yet preventable burden on the healthcare expenditure. Some herbal plants helpful in the treatment of ulcer have also been discussed here.

Effectiveness and safety of Chinese medicine combined with omeprazole in the treatment of gastric ulcer: A protocol for systematic review and meta-analysis.

Background:Gastric ulcer (GU) is a common digestive system disease, and the main clinical manifestations are nausea and epigastric pain. In recent years, due to increased life pressure, unhealthy eating habits and environment, the incidence of gastric ulcer has increased year by year. Because the disease has a long treatment cycle and is prone to relapse, if it cannot be controlled in time, it can cause the disease to prolong, affect the daily life and health of the patient, and even cause complications such as upper gastrointestinal bleeding, ulcer perforation, and pyloric obstruction. Helicobacter pylori infection is one of the main causes of GU. Clinically, the curative effect of western medicine or traditional Chinese medicine cannot reach the ideal level, so in recent years, the combination of traditional Chinese and western medicine has been highly praised. The aim of this systematic review is to evaluate the effectiveness and safety of Chinese medicine combined with omeprazole for GU.Methods:The data and information will be retrieved from the databases of PubMed, Embase, Cochrane Library, CNKI, VIP, and Wanfang data. Literature search is limited to Chinese and English. The search time range is from the establishment of the database to April 7, 2021. The search strategy uses a combination of subject terms and free words to search. In order to avoid omissions, the search scope includes subject terms, keywords, or full text. Two reviewers will independently exclude substandard articles and extract eligible data. The risk of bias will be assessed using the Cochrane Handbook 5.1.0 for Systematic Reviews of Interventions. RevMan 5.3 will be used for systematic review and meta-analysis. This protocol will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) statement, and the systematic review will be reported with the PRISMA statement.Results and conclusion:The efficacy and safety of Chinese medicine combined with omeprazole for the treatment of GU will be evaluated, and the conclusion will be published to provide medical evidence for a better clinical decision of patients with GU.

Melatonin promotes gastric healing by modulating the components of matrix metalloproteinase signaling pathway: a novel scenario for gastric ulcer management

Over the past few decades, since the induction of antibiotics and proton pump inhibitors (PPI) as a therapeutic tool in controlling gastropathy, a substantial decline in the incidence of gastric ulcer and its related manifestations has been achieved globally. However, there are a lot of skeptics on the steady rise in the list of complications following long-term use of these drugs, especially in chronic and elderly patients. Hence, the search for a sustainable cure for these gastropathies has never actually ended; this let us consider that melatonin, an endogenous antioxidant, might have a utility in this respect. Although researchers have linked melatonin with accelerated post ulcerative wound healing, many of these studies have failed to identify the confounding factors and plausible healing mechanisms. In this review, we attempt to identify the underline mechanisms as to the protective effects of melatonin on a variety of gastropathies. Based on the evidence, we select the matrix metalloproteinases (MMPs) to be the main targets of melatonin. MMPs play a key role in maintaining the balance between extracellular matrix degradation and tissue remodeling, therefore, they act as the integral connection between the ulcer manifestation and healing. Thus, gastric ulceration occurs where this balance is disrupted. Melatonin can preserve this balance during the onset of gastric ulcers. In this review, we have also discussed the effects of melatonin on the different isoforms of MMPs and their roles in gastric ulceration, respectively. We hope that this will bestow us with a better understanding of the development of the gastric ulcer, as well as its cure.

The intervention of tert-butylhydroquinone protects ethanol-induced gastric ulcer in type II diabetic rats: the role of Nrf2 pathway.

Ethanol consumption increases the prevalence of gastric ulcer (GU) in rats with type II diabetes (T2D). Induction of GU by absolute ethanol (5mL/kg or 3.94g/kg) in the animal model resembles human ulcer characteristics. The aim was to investigate the role of the nuclear factor erythroid 2-related factor 2 (Nrf2) pathway in the treatment of GU in diabetic condition. The rats were exposed to absolute ethanol 1 h before sacrifice and T2D was induced by combined exposure of high-fat diet and low dose streptozotocin. Pretreatment of tert-butylhydroquinone (tBHQ) (25 and 50mg/kg), metformin (500mg/kg), and omeprazole (20mg/kg) were given once daily for last three consecutive weeks. In ethanol-exposed diabetic rats, pretreatment with tBHQ, omeprazole, and metformin reduced gastric mucosal lesion, ulcer index, histological alterations, malondialdehyde level, and apoptosis. Furthermore, the intervention of tBHQ, omeprazole, and metformin improved the integrity of the stomach mucosa, glutathione, gastric pH, collagen, and goblet cells. tBHQ treatment improved ethanol-induced alterations of Nrf2, catalase, heat shock protein 70 (HSP70), NF-κB, and endothelin-1 expressions in diabetic rats. In diabetic conditions, the incidence of GU is increased due to elevated levels of reactive oxygen species, inflammatory mediators, depleted levels of cellular antioxidants, and altered gastric parameters. The tBHQ intervention could be a rational strategy to protect these changes.