Abstract:
:A long-term cure is now possible in more than 30% of selected patients with Zollinger-Ellison syndrome who undergo gastrinoma resection. The need, however, for continued gastric acid antisecretory therapy in these patients remains controversial. The current study was designed to determine whether post-operative antisecretory therapy is needed in patients who have undergone successful gastrinoma resection and, if so, to attempt to define criteria with which to identify patients who require therapy. Twenty-eight consecutive patients who had previously undergone curative gastrinoma resection were prospectively studied. When antisecretory therapy was discontinued, 43% (12/28) of these patients developed gastro-oesophageal reflux, diarrhoea, acid-peptic symptoms or endoscopic evidence of acid-peptic disease within 2 weeks and were deemed to have failed a trial of antisecretory drug withdrawal. The remaining 57% (16/28) of patients who successfully discontinued antisecretory therapy were followed for a mean time of 31 months after withdrawal of therapy. Analysis of acid output studies pre-operatively, as well as at the time of drug withdrawal, demonstrated that patients who were unable to discontinue antisecretory therapy exhibited higher pre-operative maximal acid output values and higher basal acid output values at the time of attempted drug withdrawal than patients who were able to discontinue therapy. Despite these findings, there was significant overlap in acid output values between groups so that it was not possible to define specific acid output criteria for successful drug withdrawal. Pre-operative clinical characteristics, such as the presence or absence of gastro-esophageal reflux or acid-peptic disease, or post-operative laboratory values, such as the fasting serum gastrin level, did not correlate with the ability to discontinue antisecretory therapy. We conclude that following successful curative gastrinoma resection, 40% of patients still require antisecretory therapy and that both symptom evaluation as well as upper endoscopy should be used to guide attempted drug withdrawal. Although patients who are not able to discontinue therapy have significantly higher acid output measurements than those who are able to discontinue therapy, neither acid output criteria nor any other laboratory or clinical characteristics are able to predict the need for continued antisecretory therapy in these patients.
journal_name
Aliment Pharmacol Therjournal_title
Alimentary pharmacology & therapeuticsauthors
Metz DC,Benya RV,Fishbeyn VA,Pisegna JR,Orbuch M,Strader DB,Norton JA,Jensen RTdoi
10.1111/j.1365-2036.1993.tb00095.xsubject
Has Abstractpub_date
1993-06-01 00:00:00pages
247-57issue
3eissn
0269-2813issn
1365-2036journal_volume
7pub_type
杂志文章abstract:BACKGROUND:The increasing incidence of Clostridium difficile (C. difficile) infection (CDI) among patients with inflammatory bowel disease is well recognised. However, most studies have focused on demonstrating that CDI is associated with adverse outcomes in IBD patients. Few have attempted to identify predictors of se...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章,多中心研究
doi:10.1111/j.1365-2036.2012.05022.x
更新日期:2012-04-01 00:00:00
abstract:BACKGROUND:Small intestinal bacterial overgrowth and sugar malabsorption (lactose, fructose, sorbitol) may play a role in irritable bowel syndrome. The lactulose breath test is a reliable and non-invasive test for the diagnosis of small intestinal bacterial overgrowth. The lactose, fructose and sorbitol hydrogen breath...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章
doi:10.1111/j.1365-2036.2005.02493.x
更新日期:2005-06-01 00:00:00
abstract:BACKGROUND:Vasoactive medications such as vasopressin, somatostatin and their analogues (terlipressin, vapreotide and octreotide) are commonly used for the treatment of acute variceal bleeding. However, the risks and benefits of these interventions are not well understood. AIM:To undertake a meta-analysis of the effic...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章,meta分析
doi:10.1111/j.1365-2036.2012.05088.x
更新日期:2012-06-01 00:00:00
abstract:BACKGROUND:Patients with chronic liver disease and components of metabolic syndrome may be at higher risk for fibrosis. AIM:To assess the impact of clinicodemographic factors on hepatic fibrosis in CLD. METHODS:Of 1028 chronic liver disease patients, 964 were included in the analysis. Extensive clinico-demographic an...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章
doi:10.1111/j.1365-2036.2010.04266.x
更新日期:2010-05-01 00:00:00
abstract:BACKGROUND:Cross-sectional studies suggest insulin resistance is strongly associated with hepatic steatosis and fibrosis in patients with chronic hepatitis C (CHC), which might affect the efficacy of antiviral therapy. Aim To investigate retrospectively the impact of insulin resistance on treatment response in Chinese ...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章
doi:10.1111/j.1365-2036.2008.03823.x
更新日期:2009-01-01 00:00:00
abstract:BACKGROUND:Proton pump inhibitors are effective for the healing of oesophagitis. Standard doses of omeprazole, lansoprazole or pantoprazole are sufficient for healing in mild to moderate cases of oesophagitis. AIM:To compare the efficacy of double the standard doses of omeprazole, lansoprazole or pantoprazole for main...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1046/j.1365-2036.1998.00278.x
更新日期:1998-01-01 00:00:00
abstract::The mode of transmission of Helicobacter pylori is largely unknown and is a matter of circumstantial evidence and speculation rather than fact. However, the principle evidence is of two sorts: the epidemiological data, providing evidence of possible risk factors associated with transmission, and the identification of ...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章,评审
doi:10.1046/j.1365-2036.2001.00111.x
更新日期:2001-06-01 00:00:00
abstract:BACKGROUND:Sphincter of Oddi dysfunction is a benign, functional gastrointestinal disorder for which invasive endoscopic therapy with potential complications is often recommended. AIMS:To review the available evidence regarding the diagnostic accuracy of non-invasive methods that have been used to establish the diagno...
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
abstract:BACKGROUND:Proton pump inhibitors (PPI) are widely used to treat acid-related disorders of the upper gastrointestinal tract. However, large observational studies have raised concerns about PPI-associated adverse events. In recent years, data from next-generation sequencing studies suggested that PPIs affect the composi...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章
doi:10.1111/apt.15604
更新日期:2020-03-01 00:00:00
abstract:BACKGROUND:Liver cirrhosis is characterized by a silent phase until decompensation, which is defined by ascites, bleeding from esophageal varices or hepatic encephalopathy. AIM:To compare the clinical course, patterns of survival and causes of death by etiology during long-term follow-up in a large population-based co...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章
doi:10.1111/apt.15255
更新日期:2019-06-01 00:00:00
abstract::Both duodenal and gastric ulcer disease are closely associated with Helicobacter pylori infection. An infected individual has an estimated lifetime risk of 10-20% for the development of peptic ulcer disease, which is at least 3-4 fold higher than in non-infected subjects. H. pylori infection can be diagnosed in 90-100...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章,评审
doi:
更新日期:1995-01-01 00:00:00
abstract::The present study examined whether histamine could affect the growth of the enterochromaffin-like (ECL) cell and the parietal cell. The effects of the unsurmountable histamine H2-receptor antagonist loxtidine (80 mg/kg) and the H+, K(+)-ATPase inhibitor omeprazole (100 mumol/kg) were compared in female Sprague-Dawley ...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章
doi:10.1111/j.1365-2036.1992.tb00055.x
更新日期:1992-06-01 00:00:00
abstract:AIM:To evaluate the Helicobacter pylori stool antigen (HpSA) test in the assessment of H. pylori infection and the effect of omeprazole treatment on its accuracy. METHODS:Study 1: 140 dyspeptic patients were enrolled in the study and defined as H. pylori positive if histology and rapid urease test, or culture alone we...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1046/j.1365-2036.2001.00907.x
更新日期:2001-01-01 00:00:00
abstract:BACKGROUND:Intravenous octreotide is an established treatment of oesophageal variceal haemorrhage in the cirrhotic patient. AIM:To examine the organ extraction and splanchnic haemodynamic effects of octreotide in cirrhotic patients with portal hypertension. METHODS:Thirteen patients with cirrhosis had hepatic venous ...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 临床试验,杂志文章
doi:10.1046/j.1365-2036.1998.00353.x
更新日期:1998-07-01 00:00:00
abstract:BACKGROUND:Gastric cancer can be divided into cardia and noncardia gastric adenocarcinoma (NCGA). Non cardia gastric cancer is a disease that has declined in global incidence but has remained as an extremely lethal cancer. AIM:To review recent advances in epidemiology and strategies in prevention of non cardia gastric...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章,评审
doi:10.1111/apt.12814
更新日期:2014-08-01 00:00:00
abstract::In a randomly allocated, double-blind, endoscopically controlled study, 98 patients with gastric ulcers were treated with either (a synthetic prostaglandin of E2-like structure) enprostil 70 micrograms b.d. or 150 mg ranitidine b.d. The healing rates at 4, 8 and 12 weeks were enprostil 57, 91 and 94% and for ranitidin...
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.1365-2036.1990.tb00511.x
更新日期:1990-12-01 00:00:00
abstract:BACKGROUND:Cyclo-oxygenase-2 expression has been reported to play an important role in the metaplasia-dysplasia-carcinoma sequence in Barrett's oesophagus. However, the existence of cyclo-oxygenase-2 expressing cells in Barrett's epithelium is still uncertain. AIM:To identify the cells that express cyclo-oxygenase-2 p...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章
doi:10.1111/j.1365-2036.2004.02195.x
更新日期:2004-10-01 00:00:00
abstract:BACKGROUND:Bismuth compounds prevent gastric injury from the short-term administration of nonsteroidal anti-inflammatory drugs. We studied the mechanisms underlying the gastroprotective actions of bismuth subsalicylate against indomethacin-induced injury in rats. METHODS:An in vivo microscopic technique was used in wh...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章
doi:10.1046/j.1365-2036.1997.00170.x
更新日期:1997-06-01 00:00:00
abstract:BACKGROUND:Studies to date have not directly compared the pharmacodynamic efficacies of different proton pump inhibitors in controlling intragastric acidity in patients treated with non-steroidal anti-inflammatory drugs. AIM:To compare acid suppression with once-daily esomeprazole 40 mg, lansoprazole 30 mg and pantopr...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1111/j.1365-2036.2006.02867.x
更新日期:2006-04-15 00:00:00
abstract:BACKGROUND:Irritable bowel syndrome (IBS) and functional dyspepsia (FD) are common functional disorders without defined pathology. Mast cells and eosinophils interact with T lymphocytes and may alter enteric nerve and smooth muscle function. AIM:To examine mast cell, eosinophil and intraepithelial lymphocyte populatio...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章
doi:10.1111/j.1365-2036.2009.03937.x
更新日期:2009-04-01 00:00:00
abstract:BACKGROUND:Liver biopsy is the gold standard in evaluating liver diseases but is susceptible to complications. Safety data on aspiration needle biopsies remain limited. AIM:To evaluate the safety of percutaneous liver biopsy performed with Klatskin needle. METHODS:Clinical and biochemical data were retrospectively re...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章
doi:10.1111/apt.13939
更新日期:2017-03-01 00:00:00
abstract:AIM:To determine factors affecting compliance of a follow-up colonoscopy in patients with previously diagnosed adenomatous colon polyps. METHODS:A retrospective review was performed on patients with adenomatous polyps excised between January and December 1998. Twenty-nine clinical factors were assessed in patients gro...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章
doi:10.1111/j.1365-2036.2006.03176.x
更新日期:2006-12-01 00:00:00
abstract:BACKGROUND:Attainment of intragastric pH < 6.0 may require high-dose continuously infused proton pump therapy. AIM:To assess the pharmacokinetic and pharmacodynamic dose-responses of continuous infusion regimens of lansoprazole. METHODS:Healthy adult subjects were assigned to lansoprazole 60-mg intravenous bolus, fol...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1365-2036.2006.02849.x
更新日期:2006-04-01 00:00:00
abstract:BACKGROUND:Approximately 20% of primary sclerosing cholangitis (PSC) patients with concomitant inflammatory bowel disease (IBD) have Crohn's disease (CD). AIM:To compare PSC/CD with other PSC patients. METHODS:Retrospective study of 240 PSC patients diagnosed between 1975 and 2012 (median follow-up 12 years). Activit...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章
doi:10.1111/apt.13516
更新日期:2016-03-01 00:00:00
abstract:BACKGROUND:In Sweden, the most common causes of liver cirrhosis are alcohol overconsumption and hepatitis C. However, recent data on the clinical characteristics of Swedish patients with cirrhosis are scarce. AIMS:To determine the incidence, clinical presentation, aetiological spectrum and survival rates of liver cirr...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章
doi:10.1111/apt.13635
更新日期:2016-06-01 00:00:00
abstract::Gastric acid suppression is the most effective medical therapy to control acidic gastro-oesophageal reflux: individuals in whom therapy fails usually have inadequate acid suppression. Twenty-four-hour intragastric pH-metry measures the percentage of time that gastric pH is above 4 or 3, the critical thresholds for tis...
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:Recently a new 'all in one' single capsule with the three components of bismuth-based triple therapy became available in trials for treating Helicobacter pylori. AIM:To investigate the efficacy and tolerability of this new capsule when combined with lansoprazole. METHODS:A total of 66 consecutive infected ...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1046/j.1365-2036.2000.00686.x
更新日期:2000-01-01 00:00:00
abstract:BACKGROUND:The most common complication after ileal pouch anal anastomosis in up to 50% of patients is an acute pouchitis. The majority of patients respond to antibiotic treatment. However, 10%-15% develops chronic antibiotic-dependent or refractory pouchitis which is usually hard to treat. AIM:To evaluate the effecti...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章,多中心研究
doi:10.1111/apt.14479
更新日期:2018-03-01 00:00:00
abstract:BACKGROUND:Combination treatment with azathioprine for 6-12 months is the preferred strategy for starting infliximab due to improved pharmacokinetics. However, optimised infliximab monotherapy with proactive dose escalations in case of low trough levels is a safer but under-studied alternative. AIM:To compare the clin...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章
doi:10.1111/apt.15179
更新日期:2019-04-01 00:00:00
abstract:BACKGROUND:Triple therapy currently forms the cornerstone of the treatment of patients with Helicobacter pylori-positive duodenal ulcer. AIM:To establish whether prolonged antisecretory therapy is necessary in patients with active duodenal ulcer. METHODS:A total of 77 patients with H. pylori-positive duodenal ulcer w...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1046/j.1365-2036.2001.01020.x
更新日期:2001-07-01 00:00:00