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Analysis of Frequently Diagnosed Gastrointestinal Disorders and Therapeutic Regimens in the Outpatients (외래환자의 위장관계 다빈도 질환과 처방 분석)

  • Kim, Min Jeong;Choi, Kyung Eob
    • Korean Journal of Clinical Pharmacy
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    • v.7 no.1
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    • pp.22-32
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    • 1997
  • The gastrointestinal disorders (GI disorders) is one of the most common diseases in Korea. The community pharmacists are often faced with the complaints of symptoms due to the GI disorders. However the drugs used to treat the GI disorders are frequently abused by the patients themselves because these drugs are easily available and have high placebo effects. Therefore, we have reviewed the digestive diseases statistics of 1996 to find out the frequencies of the GI disorders in the outpatients of Samsung Medical Center. Using these statistic data, we figured out the frequently diagnosed GI disorders and analysed commonly used prescriptions from February 1st to 28th of 1997. In addition, we also evaluated the commonly used drugs in these prescriptions. About twenty thousands of patients visited the hopital because of their GI symptoms in 1996. It was found that dyspepsia, viral hepatitis, and gastric and duodenal ulcer disease are frequently diagnosed in these patients. In a point of view on other GI disorders, gastritis and duodenitis, irritable bowel syndrome, gastroesophageal reflux disease, constipation and diarrhea were commonly detected. And a number of drugs were prescribed to treat the GI disorders, which included the prokinetics, Histamine-2 receptor antagonists, proton pump inhibitor, antacids, tranquillizers, antidepressants, antispasmodics, laxatives and so on. Interestingly, there were many prescriptions composing of the antibiotic regimens to eradicate H. pylori which has been proven to cause peptic ulcers.

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A Case of Herpes simplex Esophagitis in an Immunocompetent Boy (건강했던 남아에서 발생된 헤르페스 식도염 1예)

  • Yeo, Joong-Suk;Jeon, Je-Deok;Chang, Soo-Hee
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.11 no.1
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    • pp.70-74
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    • 2008
  • Herpes simplex virus has rarely been identified as a cause of esophagitis in immunocompetent children. This virus affects predominantly males presenting with symptoms of fever, odynophagia, dysphagia, and retrosternal pain of acute onset. Esophagoscopy typically reveals exudative well-circumscribed ulcerations of the distal and/or mid-esophagus. Further investigations using biopsy, viral culture, polymerase chain reaction (PCR), and seroconversion of antibodies to Herpes simplex are recommended to assist with a definitive diagnosis. This esophagitis is often a self-limited infection in immunocompetent children. Nevertheless, antiviral treatment may expedite symptom relief with Herpes simplex virus infection. It is imperative to document herpes esophagitis in cases with subsequent severe odynophagia in immunocompetent children. Here we present the case of a 12-year-old immunocompetent boy with herpes esophagitis.

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Inhibition of Experimental Gastric Ulcer by Potato Tubers and the Starch

  • Lee, Jun-Gi;Jin, Jeong-Ho;Lim, Hak-Tae;Choi, Hee-Don;Kim, Hyun-Pyo
    • Natural Product Sciences
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    • v.15 no.3
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    • pp.134-138
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    • 2009
  • In an attempt to establish anti-ulcerogenic activity of potato tubers, inhibitory activity against ethanol- and indomethacin-induced gastric ulcer models in rats was evaluated for the first time. From several varieties of potato tubers including Solanum tuberosum L. cv. Superior (white skin and fresh potato) and two new varieties of (Bora valley and Gogu valley), raw potato juice was prepared and the starch was obtained from each juice by filtration and drying. Upon oral administration to rats, raw potato juice showed more or less inhibitory activity. The starch showed higher and dose-dependent inhibitory activity, suggesting that the active ingredient in raw potato juice may be the starch. Particularly, the starch obtained from the tubers of new potato variety, "Bora valley," with purple color, showed the highest inhibitory activity (62.4% and 37.1% inhibition of ulcer index at 500 mg/kg), while omeprazole (proton pump inhibitor) used as a reference drug showed 74.4% and 75.7% inhibition at 20 mg/kg against ethanol- and indomethacin-induced ulcer formation, respectively. The present study provides a first evidence of anti-ulcerogenicity of raw potato juice and the starch. Especially, the starch from "Bora valley" strongly inhibited ulcer formation in rats. Considering that these are food components, they may be safely used for anti-ulcerogenic nutraceuticals.

Gastric Protective Effects of Banhasasim-tang on Indomethacin-treated Rats

  • Park, Su-Wan;Byun, Joon-Seok
    • The Journal of Internal Korean Medicine
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    • v.35 no.2
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    • pp.208-221
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    • 2014
  • Purpose : Banhasasim-tang (BHSST) has been applied for treating the symptom of gastric stuffiness, which is similar to dyspepsia. The object of this study was to observe the healing effect of BHSST on the indomethacin (IND)-induced gastric ulcer in rats. Methods : Three different dosages of BHSST (400, 200 and 100 mg/kg) were orally administered 30 min before IND treatment; 6 hrs after IND treatment, the changes on the gross lesion scores, fundic histopathology, myeloperoxidase (MPO) activity, lipid peroxidation and antioxidant defense system (glutathione contents, catalase (CAT) and superoxide dismutase (SOD) activities) were observed, and compared with the activity of the synthetic anti-ulcer drug, a representative proton pump inhibitor omeprazole (OME) 10 mg/kg. Results : All three different dosages of BHSST treatment in the IND-induced gastric ulcer rats, significant and dose dependent decreased gastric damages - hemorrhagic gross lesions, gastric mucosa MPO levels and histopathological gastric ulcerative lesions - were detected as compared with the IND treated control rats. BHSST also strengthened the antioxidant defense systems - decreased the level of lipid peroxidation and CAT activity but increased the level of GSH and SOD activity, and BHSST 200 mg/kg showed similar anti-ulcerative effect as compared with OME 10 mg/kg. Conclusions : The results obtained in this study suggest that BHSST has favorable effects against IND-induced gastric damages, through significant and dose-dependent decreasing gastric damages and the strengthening of the body's antioxidant defense systems with direct anti-inflammatory effects.

Protective Effects of BK-1202 on the Indomethacin-induced Gastric Ulcer in Rats

  • Kwon, Hae-Won;Kim, Dae-Jun
    • The Journal of Korean Medicine
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    • v.36 no.4
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    • pp.42-55
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    • 2015
  • Purpose: The object of this study is to observe the anti-ulcerative effects of BK-1202 (IGM), a mixed herbal formula consisting of 9 herbal drugs, which have been traditional Korean medicine for treating various digestive diseases, on indomethacin-induced gastric ulcer in rat. Methods: Three different doses of IGM extract (200, 100 and 50 mg/kg) were orally administered once 30 min before indomethacin treatment. Six hours after indomethacin treatment, changes in the gross lesion scores, fundic histopathology, MPO activity and antioxidant activities were observed. The results were compared with two reference groups treated with omeprazole (10 mg/kg), antioxidant and proton pump inhibitor, and DA-9601 (100 mg/kg), a standardized extract of the herb Artemisiaasiatica. Results: In all three doses of IGM extract, significantly decreased gastric damages were observed in the indomethacin-induced gastric ulcer rats, when compared with the indomethacin-treated control rats. IGM extracts also strengthened the antioxidative defense systems, decreasing the level of lipid peroxidation and catalase activity while increasing the superoxide dismutase and glutathione contents. IGM extracts showed similar anti-ulcerative effects to those shown by equal dose of DA-9601, and the effects of 50 mg/kg IGM extracts were comparable to those of 10 mg/kg omeprazole. Conclusion: The results obtained in this study suggest that IGM extract has favorable effects on the indomethacin -induced gastric damages by strengthening the antioxidative defense systems and enhancing anti-inflammatory effects.

Characteristics of ATPases Present in Everted Membrane Vesicles of Helicobacter pylori

  • Yun, Soon-Kyu;Hwang, Se-Young
    • Journal of Microbiology and Biotechnology
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    • v.7 no.3
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    • pp.167-173
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    • 1997
  • Everted membrane vesicles of Helicobacter pylori were prepared and the membrane-resided ATPases were characterized. For comparison, Escherichia coli membrane ATPases and hog gastric mucosal H,K-ATPase were employed. ATPase assay revealed that the composite enzyme pool was relatively low in specific activities, below 1/10 times than that found in E. coli. According to their inhibitory specificities, most of the ATPase pool appeared to belong to the P-type ATPase, sensitive to vanadate but not to azide. The enzyme pool was extraordinarily resistant against treatment by N,N'-dicyclohexylcarbodiimide (DCCD). Certain monovalent cations, e.g., $K^+$ or $NH_4^{+}$ stimulated the whole enzyme pool only in the presence of $Mg^{2+}$. On the contrary, $Ni^{2+}$ and $Zn^{2+}$ increased enzyme activity rather effectively without the aid of $Mg^{2+}$. Under a defined condition employed, H. pylori cells could retain the membrane ATPase pool to the extent of $17{\%}$ at pH 3.2. Moreover, its activity was most stable in acidic conditions (pH 5.4-6.4). However, cytoplasmic or peripheral ATPase pools were hardly detected under acidity (below pH 4.6).

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Effects of Yijin-tang-gamibang Extracts on Reflux Esophagitis (역류성 식도염에 대한 이진탕가미방(二陣湯加味方) 효과 연구)

  • Hwang, Gee-Young;Kim, Dae-Jun;Byun, Joon-Seok
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.23 no.5
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    • pp.1073-1079
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    • 2009
  • The object of this study was to observe the protective effects of Yijin-tang-gamibang (YJGMB), Yijin-tang has been traditionally used as Korean medicine for treating various digestive diseases. The study showed that it is effective on reflux esophagitis induced by pylorus and forestomach ligation in rats. Three different dosages of Yijin-tang-gamibang extracts, 300, 150 and 75 mg/kg, were once orally administered 1 hour before pylorus ligation. 6 groups, each of 8 rats per group were used in the present study. The results were compared with Omeprazole, antioxidant and proton pump inhibitor, 30 mg/kg treated group. Yijin-tang-gamibang extracts 300 mg/kg were showed similar or slightly lower effects as compared with 30 mg/kg of omeprazole in the present study. Detail mechanism studies should be conduced in future with the efficacy tests of individual herbal composition of Yijin-tang-gamibang and the screening of the biological active compounds in herbs.

A Review on Clinical Studies of the Acupuncture and Moxibustion Therapy for Gastroesophageal Reflux Disease in China by Searching CAJ (CAJ 검색을 통해 살펴 본 중국에서의 역류성 식도질환 침구치료 임상연구 동향에 대한 고찰)

  • Kang, Sei-Young
    • Korean Journal of Acupuncture
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    • v.32 no.1
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    • pp.1-12
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    • 2015
  • Objectives : The purpose of this study was to review the acupuncture and moxibustion therapy for gastroesophageal reflux disease(GERD) in China. Methods : The literatures were searched using the database-China Academic Journals(CAJ)(~2015.1.). Clinical studies of acupuncture and moxibustion therapy for GERD such as randomized controlled trial(RCT), non-randomized controlled trial(NRCT), case series, or case report were included. Results : Thirty studies met our inclusion criteria: 24 RCTs, 4 NRCTs, 1 case series, 1 case report. Various kinds of treatment such as body acupuncture, abdominal acupuncture, acupuncture therapy with finger on back-shu point, electroacupuncture, acupoint injection, auricular acupuncture, and moxibustion were used in the clinical studies. The treatment groups take herbal medicines at the same time in 16 studies, and proton pump inhibitor(PPI) and histamine 2 receptor antagonist were used as a comparative treatment in the most of studies. Acupuncture or moxibustion treatments were done daily or 2~3 times a week for 5 days~18 weeks. All of studies reported higher effective rate in the acupuncture or moxibustion treatment group compared to the western medication control group. Conclusions : The results of this study could be used for the future practice and the clinical research about the acupuncture and moxibustion therapy for GERD.

Dogma of Extraesophaghgeal Reflux (식도 외 역류의 도그마)

  • Park, Il-Seok
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.27 no.2
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    • pp.78-83
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    • 2016
  • Laryngopharyngeal reflux (LPR) disease is an extraoesophageal variant of gastro-esophageal reflux disease that can affect the larynx and pharynx. LPR is associated with symptoms of laryngeal irritation such as throat clearing, coughing, and hoarseness. The main diagnostic methods currently used are laryngoscopy and pH monitoring. The most common laryngoscopic signs are redness and swelling of the throat. However, these findings are not specific of LPR and may be related to other causes or can even be found in healthy individuals. Furthermore, the role of pH monitoring in the diagnosis of LPR is controversial. A therapeutic trial with proton pump inhibitors (PPIs) has been suggested to be cost-effective and useful for the diagnosis of LPR. However, the recommendations of PPI therapy for patients with a suspicion of LPR are based on the results of uncontrolled studies, and high placebo response rates suggest a much more complex and multifactorial pathophysiology of LPR than simple acid reflux. Laryngoscopy and pH monitoring have failed as reliable tests for the diagnosis of LPR. Empirical therapy with PPIs is widely accepted as a diagnostic test and for the treatment of LPR. However, further research is needed to develop a definitive diagnostic test for LPR.

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Efficacy of proton pump inhibitors and H2 blocker in the treatment of symptomatic gastroesophageal reflux disease in infants

  • Azizollahi, Hamid Reza;Rafeey, Mandana
    • Clinical and Experimental Pediatrics
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    • v.59 no.5
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    • pp.226-230
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    • 2016
  • Purpose: Gastroesophageal reflux disease (GERD) occurs in pediatric patients when reflux of gastric contents presents with troublesome symptoms. The present study compared the effects of omeprazole and ranitidine for the treatment of symptomatic GERD in infants of 2-12 months. Methods: This study was a clinical randomized double-blind trial and parallel-group comparison of omeprazole and ranitidine performed at Children Training Hospital in Tabriz, Iran. Patients received a standard treatment for 2 weeks. After 2 weeks, the patients with persistent symptoms were enrolled in this randomized study. Results: We enrolled 76 patients in the present study and excluded 16 patients. Thirty patients each were included in group A (ranitidine) and in group B (omeprazole). GERD symptom score for groups A and B was $47.17{\pm}5.62$ and $51.93{\pm}5.42$, respectively, with a P value of 0.54, before the treatment and $2.47{\pm}0.58$ and $2.43{\pm}1.15$, respectively, after the treatment (P=0.98). No statistically significant differences were found between ranitidine and omeprazole in their efficacy for the treatment of GERD. Conclusion: The safety and efficacy of ranitidine and omeprazole have been demonstrated in infants. Both groups of infants showed a statistically significant decrease in the score of clinical variables after the treatment.