Evolution of gastro-oesophageal reflux disease over 5 years under routine medical care--the ProGERD study.

Background: The evolution of gastro-oesophageal reflux disease (GERD) under current management options remains uncertain.

Aim: To examine whether, depending on the initial presentation, non-erosive (NERD) and erosive reflux disease (ERD) without Barrett's oesophagus will progress to more severe disease under current routine care following the resolution of the initial condition.

Methods: Patients with the primary symptom of heartburn were included at baseline, and stratified into non-erosive (NERD) and erosive reflux disease (ERD), LA grades A-D (Los Angeles classification).

[New epidemiology of acute gastrointestinal hemorrhage].

Due to progress in general medicine and especially in gastroenterology, the incidence of acute gastrointestinal hemorrhage could be expected to have decreased during the last 25 years. However, published epidemiological data cannot, in general, fulfill this hope. The interpretation of potential trends is, however, often limited by low study quality.

Main comedications associated with major bleeding during anticoagulant therapy with coumarins.

Objective: To study the main comedications associated with major bleeding during anticoagulant therapy with coumarins in a non-selected population under everyday circumstances.

Methods: The study population for this retrospective cohort study included all new users of phenprocoumon or acenocoumarol aged 40-80 years, during the period 1992-2000 in the PHARMO Record Linkage System. All patients were followed until the last dispensing of phenprocoumon or acenocoumarol, the first bleeding complication requiring hospitalization, death, or the end of the study period.

A summary of Food and Drug Administration-reported adverse events and drug interactions occurring during therapy with omeprazole, lansoprazole and pantoprazole.

Background: Pantoprazole is claimed to have a lower potential for drug interaction than other proton pump inhibitors.

Aim: To estimate the frequency of adverse events and drug interactions reported to the Food and Drug Administration in patients receiving omeprazole, lansoprazole or pantoprazole.

Methods: The study involved a search of the Food and Drug Administration's database for adverse events and drug interactions with omeprazole, lansoprazole or pantoprazole as primary or secondary suspect drug.

Treatment of Helicobacter pylori in functional dyspepsia resistant to conventional management: a double blind randomised trial with a six month follow up.

Background: Previous studies on the treatment of Helicobacter pylori infection in functional dyspepsia have shown little, if any, effect on dyspeptic symptoms. However, whether such treatment might be of benefit in patients resistant to acid inhibitors has not been formally tested.

Aim: The present study investigated the effect of H pylori treatment in patients with functional dyspepsia resistant to conventional treatment.

Primary prevention of diclofenac associated ulcers and dyspepsia by omeprazole or triple therapy in Helicobacter pylori positive patients: a randomised, double blind, placebo controlled, clinical trial.

Background: There is much controversy as to whether or not treatment of Helicobacter pylori reduces the occurrence of peptic ulcers during therapy with a non-steroidal anti-inflammatory drug (NSAID).

Aim: To assess the efficacy of triple therapy or omeprazole on the occurrence of diclofenac associated ulcers in H pylori positive patients.

Methods: This was a randomised, double blind, placebo controlled, multicentre trial in H pylori positive patients requiring NSAID therapy who had no past or current peptic ulcer.

Short course acid suppressive treatment for patients with functional dyspepsia: results depend on Helicobacter pylori status. The Frosch Study Group.

Background And Aims: Treatment of functional dyspepsia with acid inhibitors is controversial and it is not known if the presence of Helicobacter pylori infection influences the response.

Methods: After a complete diagnostic workup, 792 patients with functional dyspepsia unresponsive to one week of low dose antacid treatment were randomised to two weeks of treatment with placebo, ranitidine 150 mg, omeprazole 10 mg, or omeprazole 20 mg daily. Individual dyspeptic and other abdominal symptoms were evaluated before and after treatment according to H pylori status.

Helicobacter pylori and functional dyspepsia: a real causal link?

This chapter reviews the evidence for a link between functional dyspepsia and Helicobacter pylori infection from three angles. In the section on pathophysiology, we evaluate how H. pylori could theoretically produce dyspeptic symptoms: many mechanisms can be proposed.

[Gastroenterology. II: Acid research and ulcer therapy].

Three discoveries of the last thirty years have revolutionized acid research and ulcer therapy: H2-receptors and their competitive inhibition, the acid pump and its blockade and, finally, Helicobacter pylori and its central role in ulcer disease. Today the problem of ulcer treatment is more or less solved by the correct use of antibiotics, while the cure of reflux disease is still problematic: pump blockers accelerate the healing of mucosal breaks and prevent, when given at long term, recurrences but they cannot change the natural history of reflux disease. These facts form the basis for future research.

[Reflux, lung and heart].

The connections between gastroesophageal reflux, nonallergic asthma and angina pectoris are critically reviewed. Although there is no convincing evidence of a widespread pathophysiological link, such interaction may play a role in selected cases.

Comparison between esophageal Wallstent and Ultraflex stents in the treatment of malignant stenoses of the esophagus and cardia.

Background And Study Aims: Several published studies have examined various self-expanding metal esophageal stents for use in the palliative treatment of esophageal or cardiac neoplasia, but few have compared different self-expanding metal stents. The aim of this study was to evaluate non-covered Wallstent and Ultraflex prostheses in the treatment of malignancies in the esophagus and the cardiac region.

Materials And Methods: In a retrospective study, the effectiveness of non-covered Wallstents (46 patients) and Ultraflex stents (36 patients) was compared in the treatment of malignancies in the esophageal and cardiac regions.

[Recurrence of reflux esophagitis can be prevented with maintenance therapy with sucralfate].

Objective: To determine whether the recurrence of reflux oesophagitis can be prevented with sucralfate suspension 2 g daily.

Design: Double-blind, placebo-controlled, multinational drug study.

Setting: Sixteen research centres in Switzerland, Germany and the Netherlands.

Sucralfate maintenance therapy in reflux esophagitis. Sucralfate Investigational Working Team.

Objective: to prove in a double-blind placebo-controlled multinational trial the effects of sucralfate suspension 2 g BID and placebo in the prevention of recurrent reflux esophagitis.

Methods: One hundred and eighty-four patients from 16 centers with reflux esophagitis Savary grade 1 and 2 were initially healed with antisecretory therapy before entering the study. They were randomly allocated to sucralfate suspension 2 g BID or placebo for 6 months.

[Dyspepsia: work-up or provisional treatment?].

Dyspepsia is defined as symptoms that are considered by a physician to originate from the upper gastrointestinal tract. The term 'functional dyspepsia' designates dyspepsia after exclusion of organic causes. Dyspepsia is a frequent problem in general practice.

[Ulcer prevention during anti-rheumatism therapy and in intensive medicine].

Gastrointestinal side effects are common to all nonsteroidal anti-inflammatory drugs (NSAID). Relevant to the patient are NSAID-induced dyspepsia and ulcer complications such as hemorrhage and perforation. The most important prophylactic means is repeated verification that the NSAID cannot be replaced by other measures, e.

[Therapy of gastroesophageal reflux disease].

The natural history of gastroesophageal reflux disease is usually that of a chronic disorder. Spontaneous remission is rare, and cure even more so, especially in more severe cases. Treatment of esophagitis has been eased in most cases with current drugs, but recurrence is almost the rule after discontinuation of therapy.

Comparison of pantoprazole and ranitidine in the treatment of acute duodenal ulcer. Pantoprazole-Duodenal Ulcer-Study Group.

Background: Pantoprazole is a new substituted benzimidazole that blocks the H+/K(+)-ATPase in the gastric mucosa and thus inhibits acid secretion.

Methods: Efficacy and tolerability of pantoprazole (40 mg at breakfast) and ranitidine (300 mg at bedtime) in the treatment of uncomplicated acute duodenal ulcer were compared in a double-blind randomized multicentre trial.

Results: Of 202 outpatients who entered the study, 185 terminated the treatment without violation of the protocol.