Heartburn: community perceptions.

Background And Aims: To determine the prevalence of heartburn in the Australian community, and document factors precipitating it and medications used in treatment.

Methods: Telephone interviews with 1200 individuals aged 18 years or more were conducted one weekend in 1996. Each respondent was asked four questions about heartburn, its severity, factors causing it and current therapy.

Reflux disease: the view of the internist.

Pathogenesis of GERD is mainly concerned with a defective antireflux barrier to gastric and duodenal contents. Transient lower oesophageal sphincter relaxation is thought to be the main mechanism by which reflux is permitted, but the mucosal exposure time to the refluxate, the nature of the refluxed material and oesophageal clearance are important mechanisms. The Internist only sees the 'tip of the iceberg' as far as GERD is concerned, and generally these are severe resistant cases of GERD.

Relationship of satiety to postprandial glycaemic, insulin and cholecystokinin responses.

The effect of plasma glucose on satiety and the capacity of carbohydrates to stimulate cholecystokinin (CCK) remain unclear. The aim of this study was to test the hypothesis that the magnitude of the postprandial plasma glucose and insulin response is inversely related to the CCK response and to subjective satiety. Seven healthy, male volunteers consumed equal carbohydrate portions (0.

Potential regulators of feeding behavior in anorexia nervosa.

We recruited 10 patients with anorexia nervosa and 6 age- and height-matched control subjects. Basal and postprandial concentrations of glucose, insulin, cholesterol, amino acids, gastrin, and pancreatic polypeptide (PP) were measured in response to a standard mixed meal. The only satiety signal that was significantly different between the anorectic group and the control group was PP (P less than 0.

Campylobacter pylori--a role in non-ulcer dyspepsia?

Non-ulcer dyspepsia (NUD) is a common complaint in which no systematic illness or organic proximal alimentary tract disease can be identified. The pathophysiology of NUD is probably heterogeneous. Eighty-two subjects with NUD were studied in a prospective randomized placebo-controlled study to assess the efficacy of colloidal bismuth subcitrate (CBS) chewable tablets at a dose of four tablets daily for 1 month.

Effect of renal failure or portacaval shunt on release of neurotensin in man.

Neurotensin-like immunoreactivity (NTLI) is released into the circulation following a meal. However, the factors influencing its degradation and metabolism are uncertain, but it is presumed that the kidneys and liver are involved. This study has determined the release of NTLI after a liquid fat meal (200 ml 20% Intralipid) in 10 healthy control subjects, five patients with stable chronic renal failure (CRF), and five patients after a portacaval shunt (PCS), to assess the possible role of the liver and kidney in NTLI metabolism.

Central and peripheral proglumide administration and cholecystokinin-induced satiety.

Peripheral (50 mg/ml) or central (50 micrograms/microliter) injections of proglumide were made into Sprague-Dawley rats which displayed satiety-like responses after the peripheral (100 micrograms/kg) or central (50 ng in 1 microliter) administration of cholecystokinin (CCK). The satiety produced by CCK injection into the lateral hypothalamus, area postraema and ventromedial hypothalamus was significantly reversed by proglumide injections into these areas during a 4 h food intake test. Peripheral injection of proglumide after central or peripheral CCK injection did not modify this type of CCK-induced satiety.

The effect of atropine and vagal stimulation on the release of neurotensin-like immunoreactivity in man.

This study investigated the food stimulated release of neurotensin-like immunoreactivity (NTLI) in man with and without the administration of atropine, and the influence of vagal stimulation by modified sham feeding and insulin hypoglycaemia. NTLI was measured, after ethanol extraction, by specific C- and N-terminally directed antisera. With both a liquid fat meal and a mixed meal an early peak of NTLI occurred.

Comparative effects of bombesin and porcine gastrin-releasing peptide in the dog.

Bombesin and porcine gastrin-releasing peptide (GRP) share a common C-terminal decapeptide fragment and are known to have similar bioactivity. The potencies of parenterally administered GRP and bombesin have been compared in their effects on gastric acid output, serum gastrin, and serum pancreatic polypeptide. In the dose range 0-720 pmol/kg/hr, infusions of both peptides resulted in dose-related increases of gastric acid output and corresponding elevations of serum gastrin and pancreatic polypeptide.

Gastrins and gastrinomas.

The past 20 years have seen gastrin attain true hormonal status. Its structure has been characterized, it has been synthesized, radioimmunoassays for its measurement in blood and tissues have been developed and its physiology and metabolism elucidated. Of much interest to clinicians has been the association between gastrin and tumours of the pancreas (gastrinomas) and atrophic gastritis.

Immunoreactive gastrin concentrations in gastrointestinal tissues of sheep.

Radioimmunoassay of gastrin in gastrointestinal tissues of lambs and adult sheep showed highest concentrations (796 to 11,156 pmol g-1 mucosa) in the antral region of the abomasum. The next highest concentrations of gastrin were in the proximal duodenal mucosa (16 to 518 pmol g-1). Gastrin was undetectable or present in lower concentrations in caudal regions of the duodenum (less than 11 X 5 pmol g-1), the pancreas and in the body of the stomach.

Distribution of bombesin- and cholecystokinin-like immunoreactivity in rat and dog brain and gastrointestinal tract.

Using a specific bombesin radioimmunoassay and an immunoassay for cholecystokinin which sees all C-terminal fractions, the distribution of bombesin-like (BLI) and cholecystokinin-like (CCK-LI) immunoreactivity in the brain and gastrointestinal tract of the rat and dog has been studied. Both peptides are found in the brain and gut but the rat contains more CCK and BLI than the dog; this is particularly noted in the stomach, colon and cerebral cortex whereas the small intestine of both species contains equivalent amounts of peptides. This contrasts with other comparative studies, mainly on nervous system CCK, which find no major distribution differences in man, monkey, pig and rat.

Ventricular, paraventricular and circumventricular structures involved in peptide-induced satiety.

Cholecystokinin, bombesin or gastrin (2 microliter of 50 ng/microliter) was injected stereotaxically into the paraventricular nucleus of the hypothalamus, the arcuate/ventromedial area, the subfornical organ, the area postrema and the cerebral aqueduct of Sprague-Dawley rats and the effects of these injections on food and water intake were studied. While the injection of cholecystokinin reduced food intake when it was injected into both hypothalamic loci, food and water intake were most severely affected by the injection of this peptide into the cerebral aqueduct. Bombesin reduced food intake after its injection into all areas except the subfornical organ and reliable reductions in water intake were seen after injection of this peptide into all areas except the paraventricular nucleus.

The role of some central catecholamine systems in cholecystokinin-induced satiety.

Cholecystokinin (CCK), bombesin and gastrin were stereotaxically injected into catecholamine (CA) innervated areas of the lateral hypothalamus (LH), the nucleus caudatus putamen (NP) and the olfactory tubercle (OT) in male Sprague Dawley rats. Bilateral injections of 100 ng of CCK in 2 microliters of vehicle into the LH produced a slight but significant decrease in food intake during the first hour of a 4 hour eating test. The other peptides when injected into any of the brain areas did not significantly alter food intake.

The influence of smoking on the healing of duodenal ulcer treated with oxmetidine or cimetidine.

The influence of smoking on duodenal ulcer healing was examined during a double blind study of 83 patients randomly allocated to oxmetidine or cimetidine treatment. Smoking habits were recorded but patients were not advised to change these. Smokers and nonsmokers were similar clinically and did not differ in compliance with medication.

Reduction in mortality from upper gastrointestinal haemorrhage.

A study of 2377 cases of haemorrhage from the upper gastrointestinal tract shows a significant fall in mortality rate--from 15.5% in the period of retrospective study from 1961 to 1970 to 7% in the prospective study from 1972 to 1982. The fall in mortality rate from non-variceal bleeding was from 12.