Abstract:
:Chemotherapy and radiotherapy, whilst highly effective in the treatment of neoplasia, can also cause damage to healthy tissue. In particular, the alimentary tract may be badly affected. Severe inflammation, lesioning and ulceration can occur. Patients may experience intense pain, nausea and gastro-enteritis. They are also highly susceptible to infection. The disorder (mucositis) is a dose-limiting toxicity of therapy and affects around 500 000 patients world-wide annually. Oral and intestinal mucositis is multi-factorial in nature. The disruption or loss of rapidly dividing epithelial progenitor cells is a trigger for the onset of the disorder. However, the actual dysfunction that manifests and its severity and duration are greatly influenced by changes in other cell populations, immune responses and the effects of oral/gut flora. This complexity has hampered the development of effective palliative or preventative measures. Recent studies have concentrated on the use of bioactive/growth factors, hormones or interleukins to modify epithelial metabolism and reduce the susceptibility of the tract to mucositis. Some of these treatments appear to have considerable potential and are at present under clinical evaluation. This overview deals with the cellular changes and host responses that may lead to the development of mucositis of the oral cavity and gastrointestinal tract, and the potential of existing and novel palliative measures to limit or prevent the disorder. Presently available treatments do not prevent mucositis, but can limit its severity if used in combination. Poor oral health and existing epithelial damage predispose patients to mucositis. The elimination of dental problems or the minimization of existing damage to the alimentary tract, prior to the commencement of therapy, lowers their susceptibility. Measures that reduce the flora of the tract, before therapy, can also be helpful. Increased production of free radicals and the induction of inflammation are early events in the onset of mucositis. Prophylactic administration of scavengers or anti-inflammatories can partially counteract or limit some of these therapy-mediated effects, as can the use of cryotherapy. The regular use of mouthwashes, mouth coatings, antibiotics and analgesics is essential, prior to and during loss and ablation of the epithelial layer. Granulocyte-macrophage colony-stimulating factor/granulocyte colony-stimulating factor or the use of laser light therapy may aid restitution and repair. Glutamine supplements may be beneficial in the repair/recovery phase.
journal_name
Aliment Pharmacol Therjournal_title
Alimentary pharmacology & therapeuticsauthors
Duncan M,Grant Gdoi
10.1046/j.1365-2036.2003.01784.xsubject
Has Abstractpub_date
2003-11-01 00:00:00pages
853-74issue
9eissn
0269-2813issn
1365-2036pii
1784journal_volume
18pub_type
杂志文章,评审abstract::Forty-two patients with peptic ulceration of the duodenum, stomach or oesophagus, who had not responded to 3 or more months of high-dose treatment with ranitidine (450 or 600 mg/day), were treated with oral lansoprazole at 30-60 mg daily. In 40 patients (95.2%) the ulcers healed within 2-12 weeks. In the remaining 2 p...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 临床试验,杂志文章
doi:10.1111/j.1365-2036.1993.tb00589.x
更新日期:1993-01-01 00:00:00
abstract:BACKGROUND:Non-alcoholic fatty liver disease affects 10-35% of the adult population worldwide; there is no consensus on its treatment. Omega-3 fatty acids have proven benefits for hyperlipidaemia and cardiovascular disease, and have recently been suggested as a treatment for non-alcoholic fatty liver disease. AIMS:To ...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章,评审
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journal_title:Alimentary pharmacology & therapeutics
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abstract:BACKGROUND:Serum vitamin D levels are associated with bone complications in patients with primary biliary cirrhosis (PBC). Increasing evidence suggests a nonskeletal role of vitamin D in various autoimmune and liver diseases. AIM:To investigate the clinical relevance of vitamin D levels in PBC, especially their associ...
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更新日期:2015-07-01 00:00:00
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doi:10.1111/j.1365-2036.2006.03242.x
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更新日期:2015-09-01 00:00:00
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journal_title:Alimentary pharmacology & therapeutics
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abstract:BACKGROUND:Direct-acting anti-virals (DAA) are safe, effective treatment of hepatitis C virus (HCV). Suboptimal linkage to specialists and access to DAAs are the leading barriers to treatment; however, data are limited. AIM:To determine predictors of follow-up, receipt of DAAs, and reasons for the lack thereof. METHO...
journal_title:Alimentary pharmacology & therapeutics
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更新日期:2017-11-01 00:00:00
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journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章,评审
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更新日期:2004-09-01 00:00:00
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journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章
doi:10.1046/j.1365-2036.1996.22164006.x
更新日期:1996-04-01 00:00:00
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journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章,随机对照试验
doi:10.1111/apt.12855
更新日期:2014-09-01 00:00:00
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journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章,评审
doi:10.1046/j.1365-2036.1996.22164019.x
更新日期:1996-01-01 00:00:00
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journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章
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更新日期:2010-12-01 00:00:00
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journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章,评审
doi:10.1046/j.1365-2036.17.s1.3.x
更新日期:2003-02-01 00:00:00
abstract:BACKGROUND:In developed countries, hepatitis E is a porcine zoonosis caused by hepatitis E virus (HEV) genotype 3. In developing countries, hepatitis E is mainly caused by genotype 1, and causes increased mortality in patients with pre-existing chronic liver disease (CLD). AIM:To determine the role of HEV in patients ...
journal_title:Alimentary pharmacology & therapeutics
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更新日期:2015-09-01 00:00:00
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journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章,随机对照试验
doi:10.1111/apt.12057
更新日期:2012-11-01 00:00:00
abstract::Unfractioned heparin was recently reported to be beneficial in the treatment of inflammatory bowel disease. The available uncontrolled data show that it may be effective in steroid-resistant ulcerative colitis with a percentage of complete clinical remission of over 70% after an average of 4-6 weeks of therapy. The ad...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章,评审
doi:10.1046/j.1365-2036.2000.00860.x
更新日期:2000-11-01 00:00:00
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journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章,评审
doi:10.1111/j.1365-2036.2006.02971.x
更新日期:2006-07-15 00:00:00
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journal_title:Alimentary pharmacology & therapeutics
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1111/j.1365-2036.1993.tb00128.x
更新日期:1993-10-01 00:00:00
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journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章,评审
doi:10.1111/apt.14913
更新日期:2018-09-01 00:00:00
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journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1365-2036.2008.03622.x
更新日期:2008-05-01 00:00:00
abstract:BACKGROUND:The effect of direct-acting anti-virals (DAAs) in children and adolescents with chronic hepatitis C virus (HCV) infection is difficult to determine, since few, aged between 3 and 18 years, have been enrolled in clinical trials, and some data come from observational studies. AIM:To summarise the evidence on ...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章,meta分析
doi:10.1111/apt.16037
更新日期:2020-10-01 00:00:00
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journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章
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更新日期:2018-01-01 00:00:00
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journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章,多中心研究
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更新日期:2006-07-15 00:00:00
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journal_title:Alimentary pharmacology & therapeutics
pub_type: 临床试验,杂志文章
doi:10.1111/j.1365-2036.2007.03583.x
更新日期:2008-02-15 00:00:00
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journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章,评审
doi:10.1111/j.1365-2036.2004.02237.x
更新日期:2004-12-01 00:00:00
abstract:BACKGROUND:Some patients requiring acid suppression may be unable to take oral medications. AIM:To compare the gastric acid inhibition effects of lansoprazole 30 mg administered either intravenous or orally in erosive oesophagitis patients. METHODS:The study included 87 Helicobacter pylori-negative patients with eros...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
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更新日期:2004-10-15 00:00:00
abstract:BACKGROUND:Regulatory requirements for claims of mucosal healing in ulcerative colitis (UC) will require demonstration of both endoscopic and histologic healing. Quantifying these rates is essential for future drug development. AIMS:To meta-analyse endoscopic and histologic placebo response and remission rates in UC r...
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pub_type: 杂志文章,meta分析
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更新日期:2018-06-01 00:00:00
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journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2010-08-01 00:00:00
abstract:BACKGROUND:The Gut and Obesity Asia (GO ASIA) workgroup was formed to study the relationships between obesity and gastrointestinal diseases in the Asia Pacific region. AIM:To study factors associated with nonalcoholic steatohepatitis (NASH) and advanced fibrosis, and medical treatment of biopsy-proven nonalcoholic fat...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章
doi:10.1111/apt.14506
更新日期:2018-03-01 00:00:00