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What alternate treatments exist for patients with gastritis?
Scientists have experimented with quadruple therapy, which adds an antisecretory drug, or one which suppresses gastric secretion, to the standard triple therapy.
What is the triple therapy for helicobacter pylori?
The preferred treatment for helicobacter pylori (H. pylori) infection is triple therapy for two weeks withmetronidazole (250mg, three times daily)a bismuth compound, which prevents degradation of the mucous layer bismuth subsalicylate - Pepto-Bismol available in the US (2 tablets, four times a day)available as colloidal bismuth subcitrate (De-Nol) elsewhere (120 mg, four times daily)either tetracycline (500 mg, four times daily) or amoxicillin (500 mg, three times daily)This triple therapy produces eradication of H. pylori in about 90% of patients. Sometimes, the triple therapy is added to an antisecretory medication (H2 receptor antagonist or almost always, a proton pump inhibitor) which may be used for up to 6 months or prophylactically. Lastly, a urea breath test is used to insure completion of a successful therapy.
What is ulpax?
Ulpax is a proton pump inhibitor which prevents the stomach from producing acid. It is manufactured by TAP Pharmaceutical Products. Ulpax has been marketed for many years and is one of several PPI's available.Ulpax, an acid proton-pump inhibitor similar to omeprazole, is used as an untiulcer drug in the treatment and maintenance of healing of duodenal or gastric ulcers, erosive and reflux esophagitis, NSAID-induced ulcer, Zollinger-Ellison syndrome, and Barrett's esophagus. Lansoprozole is active against Helicobacter pylori. The plasma elimination half-life of lansoprazole does not reflect its duration of suppression of gastric acid secretion. Thus, the plasma elimination half-life is less than two hours, while the acid inhibitory effect lasts more than 24 hours.Lansoprazole is used short-term (4-8 weeks) to treat duodenal ulcer and erosive esophagitis. It may used long term to treat Zollinger-Ellison syndrome, a problem with too much acid being secreted. Lansoprazole capsules should be taken before eating. The capsules are delayed release' meaning they work over time. The capsules should be swallowed whole and not crushed, opened or chewed. If you are taking theophylline, you may need your dosage checked when you start and stop lansoprazole to ensure your dose is effective. If you are taking sucralfate, it should be taken 30 minutes after taking lansoprazole. The most common side effects reported were diarrhea, nausea and abdominal pain. These occurred in fewer than 5% of patients. If your symptoms return after completing your course of therapy, talk to your physician for further evaluation. Lansoprazole is metabolized through the cytochrome P450 system, specifically through the CYP3A and CYP2C19 isozymes. Studies have shown that lansoprazole does not have clinically significant interactions with other drugs metabolized by the cytochrome P450 system, such as warfarin, antipyrine, indomethacin, ibuprofen, phenytoin, propranolol, prednisone, diazepam, clarithromycin, or terfenadine in healthy subjects. These compounds are metabolized through various cytochrome P450 isozymes including CYP1A2, CYP2C9, CYP2C19, CYP2D6, and CYP3A. When lansoprazole was administered concomitantly with theophylline (CYP1A2, CYP3A), a minor increase (10%) in the clearance of theophylline was seen. Because the small magnitude and the direction of the effect on theophylline clearance, this interaction is unlikely to be clinical concern. Nonetheless, individual patients may require additional titration of their theophylline dosage when lansoprazole is started or stopped to ensure clinically effective blood levels. Lansoprazole has also been shown to have no clinically significant interaction with amoxicillin. In a single-dose crossover study examining lansoprazole 30 mg and omeprazole 20 mg each administered alone and concomitantly with sucralfate 1 gram, absorption of the proton pump inhibitors was delayed and their bioavailability was reduced by 17% and 16%, respectively, when administered concomitantly with sucralfate. Therefore, proton pump inhibitors should be taken at least 30 minutes prior to sucralfate. In clinical trials, antacids were administered concomitantly with lansoprazole delayed-release capsules; this did not interfere with its effect. Lansoprazole causes a profound and long lasting inhibition of gastric acid secretion; therefore, it is theoretically possible that lansoprazole may interfere with the absorption of drugs where gastric pH is an important determinant of bioavailability (e.g. ketoconazole, ampicillin esters, iron salts, digoxin). Lansoprazole is contraindicated in patients with known hypersensitivity to any component of the formulation. Lansoprazole delayed-release capsules are contraindicated in patients with known hypersensitivity to any component of the formulation. Amoxicillin is contraindicated in patients with a known hypersensitivity to any penicillin. (Please refer to full prescribing information for amoxicillin before prescribing.) Clarithromycin is contraindicated in patients with a known hypersensitivity to any macrolide antibiotic, and in patients receiving terfenadine therapy who have preexisting cardiac abnormalities or electrolyte disturbances. (Please refer to clarithromycin before prescribing.) Ulpax Indication: For treatment of Acid-reflux disorders (GERD), peptic Ulcer Disease, duodenal ulcers, esophagitis, and Zollinger-Ellison syndromeMechanism Of Action: Ulpax belongs to a class of antisecretory compounds, the substituted benzimidazoles, that do not exhibit anticholinergic or histamine H2-receptor antagonist properties, but rather suppress gastric acid secretion by specific inhibition of the (H+,K+)-ATPase enzyme system at the secretory surface of the gastric parietal cell. Because this enzyme system is regarded as the acid (proton) pump within the parietal cell, Ulpax has been characterized as a gastric acid-pump inhibitor, in that it blocks the final step of acid production. This effect is dose-related and leads to inhibition of both basal and stimulated gastric acid secretion irrespective of the stimulus.Drug Interactions: Atazanavir This gastric pH modifier decreases the levels/effects of atazanavirEnoxacin The agent decreases the absorption of enoxacinIndinavir Omeprazole decreases the absorption of indinavirItraconazole The proton pump inhibitor decreases the absorption of imidazoleKetoconazole The proton pump inhibitor decreases the absorption of imidazoleSucralfate Sucralfate decreases the effect of lansoprazoleFood Interactions: Avoid alcohol.Take 30-60 minutes before meals.Food reduces bioavailabilty, but this has very little clinical impact.Generic Name: LansoprazoleSynonyms: Not AvailableWhere to order Lansoprazole (and Ulpax analogs) online:Generic Prevacid - Lansoprazole (on DrugsPill.com)Drug Category: Anti-Ulcer Agents; Anti-Infectives; Proton-pump InhibitorsDrug Type: Small Molecule; ApprovedOther Brand Names containing Lansoprazole: Agopton; Amarin; Aprazol; Bamalite; Biuret; Biuret Gr; Biuret Reagent; Biuret Reagent Solution; Blason; Compraz; Dakar; Ilsatec; Ketian; Lancid; Lanproton; Lansopep; Lansoprazol [Inn-Spanish]; Lansoprazole [Usan:Ban:Inn]; Lansoprazolum [Inn-Latin]; Lanston; Lanz; Lanzol-30; Lanzopral; Lanzor; Lasoprol; Limpidex; Mesactol; Monolitum; Ogast; Ogastro; Opiren; Prevacid; Prevacid Iv; Prevacid Solutab; Prevpac; Prezal; Pro Ulco; Promp; Prosogan; Suprecid; Takepron; Ulpax; Zoprol; Zoton;Absorption: The absorption of lansoprazole is rapid, with mean Cmax occurring approximately 1.7 hours after oral dosing, and relatively complete with absolute bioavailability over 80%.Toxicity (Overdose): Symptoms of overdose include abdominal pain, nausea and diarrhea.Protein Binding: 97%Biotransformation: Hepatic. Two metabolites have been identified in measurable quantities in plasma (the hydroxylated sulfinyl and sulfone derivatives of lansoprazole). These metabolites have very little or no antisecretory activity. Lansoprazole is thought to be transformed into two active species which inhibit acid secretion by (H+,K+)-ATPase within the parietal cell canaliculus, but are not present in the systemic circulation.Half Life: 1.5 (± 1.0) hoursDosage Forms of Ulpax: Tablet, delayed release OralCapsule, delayed release OralChemical IUPAC Name:2-[[3-methyl-4-(2,2,2-trifluoroethoxy)pyridin-2-yl]methylsulfinyl]-1H-benzimidazoleChemical Formula: C16H14F3N3O2SLansoprazole on Wikipedia:http://en.wikipedia.org/wiki/LansoprazoleOrganisms Affected: Humans and other mammals
What is a hiatal hernia?
A hiatus hernia or hiatal hernia is the protrusion (or herniation) of the upper part of the stomach into the thorax through a tear or weakness in the diaphragm. The symptoms include acid reflux, and pain, similar to heartburn, in the chest and upper stomach. In most patients, hiatus hernias cause no symptoms. Sometimes patients experience heartburn and regurgitation, when stomach acid refluxes back into the esophagus. The following are possible causes or contributing factors for having a hiatus hernia: * Obesity * Frequent coughing * Straining with constipation * Frequent bending over or heavy lifting * Heredity * Smoking * Stress The diagnosis of a hiatus hernia is typically made through an upper GI series or endoscopy. There are two major kinds of hiatus hernia: * The most common (95%) is the sliding hiatus hernia, where the gastroesophageal junction moves above the diaphragm together with some of the stomach. * The second kind is rolling (or paraesophageal) hiatus hernia, when a part of the stomach herniates through the esophageal hiatus beside, and without movement of, the gastroesophageal junction. It is about 100 times less common than the first kind. A third kind is also sometimes described, and is a combination of the first and second kinds. In most cases, sufferers experience no discomfort and no treatment is required. However, when the hiatal hernia is large, or is of the paraesophageal type, it is likely to cause esophageal stricture and discomfort. Symptomatic patients should elevate the head of their beds and avoid lying down directly after meals until treatment is rendered. If the condition has been brought on by stress, stress reduction techniques may be prescribed, or if overweight, weight loss may be indicated. Medications that lower the lower esophageal sphincter (or LES) pressure should be avoided. Antisecretory drugs like proton pump inhibitors and H2 receptor blockers can be used to reduce acid secretion. Where hernia symptoms are severe and chronic acid reflux is involved, surgery is sometimes recommended, as chronic reflux can severely injure the esophagus and even lead to esophageal cancer. The surgical procedure used is called Nissen fundoplication. In fundoplication, the gastric fundus (upper part) of the stomach is wrapped, or plicated, around the inferior part of the esophagus, preventing herniation of the stomach through the hiatus in the diaphragm and the reflux of gastric acid. The procedure is now commonly performed laparoscopically. With proper patient selection, laparoscopic fundoplication has low complication rates and a quick recovery. Complications include gas bloat syndrome, dysphagia (trouble swallowing), dumping syndrome, excessive scarring, and rarely, achalasia. The procedure sometimes fails over time, requiring a second surgery to make repairs. [1] 1. http://en.wikipedia.org/wiki/Hiatal_herniaThere are different types of hiatal hernias. I had a sliding hernia, which is the most common. It's not as bad as it sounds, as only about 50% of the people who have one, feel any discomfort. The sphincter in your esophagus opens a little bit (causing acid reflux) and part of your stomach can slide up and down your diaphragm. It's usually just a little bit and the top part of your esophagus (above your diaphragm and connects to your stomach) gets irritated and creates a hernia. Most people don't notice it but for those who do, it's painful.
