摘要:

SUMMARYEnteric‐coated microspheres of pancreatin were compared with non‐enteric‐coated pancreatin combined with cimetidine taken 40 min before meals in the treatment of patients with cystic fibrosis. Fourteen adults with steatorrhoea due to cystic fibrosis were investigated in an open, randomized crossover study, over two consecutive 28‐day treatment periods. Lipase intake was adjusted to each patient's previous requirements and was the same during both months; they were instructed to continue with their normal diet. Patients collected faeces for 72 h at the end of each month and completed diary cards daily throughout. Bowel actions were less frequent on enteric‐coated microspheres of pancreatin than on non‐enteric‐coated pancreatin/cimetidine (1.7vs.2.4/day;P<0.001) and stool character was improved (P<0.001). Mean daily faecal weight was similar on enteric‐coated microspheres of pancreatin to that on the combination (254 gvs.291 g; N.S.), whereas daily faecal fat excretion tended to be less on enteric‐coated microspheres of pancreatin (21 gvs.27 g; N.S.), and percentage fat absorption tended to be greater (81%vs.73%; N.S.). Mean body weight increased by 0.3 kg on enteric‐coated microspheres of pancreatin and fell by 0.1 kg on the combination (N.S.). These data indicate that enteric‐coated microspheres of pancreatin are at least as effective as non‐enteric‐coated pancreatin with cimetidine in the treatment of steato

ISSN:0269-2813    

DOI:10.1111/j.1365-2036.1988.tb00720.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

SUMMARYIn a Swedish double‐blind multicentre study, omeprazole (30 mg o.m.) was compared with the H2‐receptor antagonist cimetidine (400 mg b.d.) in 152 patients. Clinical assessments and laboratory investigations were carried out at 2 and 4 weeks, and again at 6 weeks in unhealed patients. Endoscopy was performed at 2 weeks, and again at 4 and 6 weeks in unhealed patients. The patients in the two groups were well‐matched prior to treatment.Omeprazole was superior to cimetidine in ulcer‐healing rate after 2, 4 and 6 weeks. After 2 weeks of treatment, 66% of the omeprazole‐ and 45 % of the cimetidine‐treated patients were healed (P= 0.02), after 4 weeks 97 and 84% (P= 0.01), and after 6 weeks 100 and 92% (P= 0.02), respectively.There was a more pronounced improvement in the patients' symptoms in the omeprazole group after 2 weeks (P= 0.05).Both drugs were well‐tolerated, but there was a high prevalence of patients with adverse events in the cimetidine group (51%, compared to 30% of the omeprazole group;P= 0.02).A total of 125 patients were followed for 6 months after healing. The patients were investigated by endoscopy after 6 months, or whenever symptoms occurred. There was no significant difference in the rate of relapse within 6 months between the two treatment groups: 54% relapsed in the omeprazole group and 52 % in the cimetidine group.In conclusion, 30 mg of omeprazole, given once daily, is superior to 400 mg of cimetidine twice daily in duodenal ulcer healing; but ulcer relapse in the two groups appears to

ISSN:0269-2813    

DOI:10.1111/j.1365-2036.1988.tb00721.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

SUMMARYThe aim of the present study was to evaluate the effect of the pancreatic enzyme preparation Kreon on abdominal symptoms, bowel habits, faecal fat excretion and oro‐caecal transit time in patients after total gastrectomy for carcinoma of the stomach with Roux‐en‐Y anastomosis. A hydrogen breath test was carried out in each patient to detect bacterial overgrowth.In a double‐blind crossover trial, 15 patients were treated with either Kreon or placebo (3.6 g/day) in two test‐periods each of seven days.During treatment with the active substance, the stool consistency became more solid (P350 mmol/72 h; upper reference limit 60 mmol/72 h) a significant (P<0.05) reduction from a median excretion of 643 mmol/72 h to 501 mmol/72 h was seen. Such a decrease in faecal fat excretion did not occur in patients with steatorrhoea below this limit. Bacterial overgrowth or rapid upper intestinal transit were not over‐represented in patients with a high‐degree of steatorrhoea.We conclude that after total gastrectomy pancreatic enzyme substitution reduces massive steatorrhoea and improves st

ISSN:0269-2813    

DOI:10.1111/j.1365-2036.1988.tb00722.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

SUMMARYBRL 24924 is a new gastrointestinal prokinetic agent with properties similar to metoclopramide but with increased potency and devoid of side‐effects associated with blockade of dopamine receptors in the central nervous system. A double‐blind placebo‐controlled trial of the effect of a single oral dose of 2.2 mg BRL 24924 on lower oesophageal sphincter pressure and gastro‐oesophageal reflux has been performed in 20 healthy volunteers. BRL 24924 significantly increased mean lower oesophageal sphincter pressure (21.9 cmH2O BRL; 15.9 cmH2O placebo:P<0.017) but failed to alter either the frequency or the duration of gastrooesophageal reflux after provocation following a test meal. BRL 24924 has significant effects on lower oesophageal sphincter pressure but no effect on provoked post‐prandial reflux in healthy volunteers. Further studies in patients with gastro‐oesophageal reflux and oesophagitis are needed to evaluate the clinical efficacy of th

ISSN:0269-2813    

DOI:10.1111/j.1365-2036.1988.tb00723.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

SUMMARYOvernight gastric secretion of acid and pepsin was studied in nine, healthy, male volunteers on two separate occasions, in randomized order. On one day, each individual received a standard meal at 18.00 hours, followed by an oral dose of 300 mg ranitidine at 18.15 hours. During the second study, 300 mg ranitidine was again taken at 18.15 hours, but the meal was consumed at 22.00 hours.Gastric juice was sampled hourly from 19.00 to 24.00 hours and then aspirated completely and continuously until 08.00 hours the next morning. Median pH values were significantly lower and median acidity was significantly higher, when the meal was eaten at 22.00 hours. The outputs of acid and pepsin after midnight were also significantly greater following the late night meal.It seems that food interferes with the gastric inhibitory effects of the currently used H2‐receptor antagonists, such as ranitidine. We conclude that H2‐receptor antagonists must be taken after the last meal of the day in order to ensure maximal therapeutic effic

ISSN:0269-2813    

DOI:10.1111/j.1365-2036.1988.tb00724.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

SUMMARYPolydextrose is a new soluble food ingredient which cannot be digested by intestinal enzymes and so may affect colonic function. Studies in healthy volunteers compared the effects of diet supplementation with 30 g/day polydextrose, a standard dose of 7 g/day ispaghula and two mixtures containing 2 g/day ispaghula with either 30 g/day polydextrose or 10 g/day polydextrose with a control period. During the 10‐day periods, the mass, frequency and consistency of faeces were assessed as well as the whole‐gut transit time, ease of defaecation, flatulence and palatability of the preparations.All preparations significantly increased the weekly faecal mass above control values (P0.05). Both preparations supplying 30 g/day polydextrose softened stool consistency equally but the other preparations had no effect. All preparations caused flatulence and other gas‐related problems but polydextrose caused more than ispaghula, even at the lowest dose of 10 g/day. More volunteers preferred taking the polydextrose drinks than the sachets of ispaghula which formed a viscous drink with water.Despite superior palatability and equally effective stool bulking, polydextrose is unlikely to be an alternative laxative to ispaghula because of the unacceptable levels of flatu

ISSN:0269-2813    

DOI:10.1111/j.1365-2036.1988.tb00725.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

SUMMARYThe impact of cimetidine, ranitidine and placebo on the pharmacokinetics of metoprolol, given either as a single dose (100 mg) or for 7 days (100 mg b.d.), has been evaluated in two separate studies. The doses used were 800 mg cimetidine daily and 300 mg ranitidine daily. The subjects were all young, healthy volunteers. In the single dose study, cimetidine produced a marked increase in the peak plasma concentration of metoprolol and in the area under the plasma concentration‐time curve; ranitidine had less effect, though the area under the curve was significantly greater than placebo. In the chronic dosing study, the area under the curve for metoprolol was also significantly higher on cimetidine (1796 ng h/ml;P<0.001) whereas the area under the curve on ranitidine (1258 ng h/ml) was comparable to that on placebo (1183 ng h/ml). Despite these drug‐induced changes in plasma metoprolol concentration, neither cimetidine nor ranitidine altered the change in exercise‐induced heart rate during dosing with metop

ISSN:0269-2813    

DOI:10.1111/j.1365-2036.1988.tb00726.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

SUMMARYAnalysis of clinical data obtained in a double‐blind randomized study, which compared liquid antacid (neutralizing capacity 120 mmol per day) with 1 g cimetidine in the treatment of 125 patients with gastric ulcer, revealed that, before starting treatment 71 % of the patients complained of epigastric pain, approximately 50% of bloating, and approximately 30 % of nausea, heartburn, constipation or vomiting.Epigastric pain before treatment was significantly more frequent in patients with large ulcers (P<0.05) and in patients with ulcers unhealed after 4 weeks of therapy (P<0.05). This finding was the result of a highly significant correlation between diurnal epigastric pain and ulcer size and delayed healing (P<0.005). Nocturnal pain did not correlate with prognosis.In contrast to this correlation between pain before therapy and healing, the disappearance of epigastric pain with therapy did not signify ulcer healing. Only 14 (38%) of the 37 patients with healed ulcer were free from pain after the 4 weeks of therapy, whereas 25 (49%) of the 52 patients with persistent ulcers had no pain at this time. Placebo pain tablets relieved ulcer pain effectively in more than 85% of the patients, irrespective of whether the ulcer was healing or not. The other symptoms (bloating, nausea, heartburn, constipation or vomiting) were also alleviated by 4 weeks of therapy but no correlation was found with ulcer size or prognosis.The loss of the prognostic significance of ulcer pain is probably due to a complex interaction of the trial schedule on the patient's level of consciousness. The highly effective placebo pain tablets and improvement of symptoms, which are unlikely to be due to gastric ulcer symptoms that are also unlikely to be affected by a decrease in gastric acidity such as bloating and constipation), suggest that ulcer treatment in a controlled trial changes pain perception. We conclude that treatment trials have effects that go beyond the rates of healin

ISSN:0269-2813    

DOI:10.1111/j.1365-2036.1988.tb00727.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

SUMMARYA double‐blind crossover trial of the α2agonist lidamidine hydrochloride in 72 patients with irritable bowel syndrome is reported. Lidamidine was found to have no significant effect on frequency and severity of abdominal pain or abdominal bloating. It did cause a statistically significant reduction in frequency of defaecation (P= 0.005), but this was of a degree unlikely to be of clinical importance. Although α2agonists inhibit gastrointestinal motility in animals this study suggests that lidamidine hydrochloride does not have a useful therapeutic role in irritable bowel syndr

ISSN:0269-2813    

DOI:10.1111/j.1365-2036.1988.tb00728.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

SUMMARYIntragastric pH‐metry was utilized to assess the effect of the time of meal ingestion and ranitidine administration on 24‐h intragastric acidity. Twelve volunteers with a documented history of duodenal ulcer were studied in a four‐way crossover design. Subjects randomly received ranitidine at 18.00 and 22.00 hours, with and without food. Serial blood samples were collected and analysed for ranitidine by high pressure liquid chromatography. Over the interval of 18.00–0.700 hours, the mean hydrogen‐ion activity was significantly lower with the 18.00 hour dose than with the 22.00 hour dose (P≤ 0.05). There were no differences between the four treatments in median pH or mean hydrogen‐ion activity over the 23‐h study interval. There were no differences between treatments in peak ranitidine concentrations, time to peak concentration, area under the serum‐concentration time curve or elim

ISSN:0269-2813    

DOI:10.1111/j.1365-2036.1988.tb00729.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY