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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Digestive diseases and sciences 36 (1991), S. 1685-1690 
    ISSN: 1573-2568
    Keywords: H2-receptor antagonists ; continuous 24-hr pH monitoring ; duodenal ulcer ; tolerance ; rebound hyperacidity ; intragastric acidity
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Tolerance to the antisecretory effects of H2-receptor antagonists develops consistently in healthy volunteers. The aim of this study was to determine whether tolerance occurs with repeated dosing of H2-receptor antagonists in patients with duodenal ulcer. Continuous intragastric 24-hr pH measurements were performed in 12 patients with duodenal ulcer in symptomatic remission before, on days 1 and 29, and two days after receiving ranitidine 300 mg four times a day for 34 days. The 24-hr median intragastric pH (interquartile range) was 5.4 (4.4–6.1) on day 1 and 4.6 (4.0–5.2) on day 29 of dosing with ranitidine (not significant). Median nighttime pH was 6.8 (6.3–7.0) on day 1 and 6.8 (6.6–7.1) on day 29 (not significant). During the daytime, the median pH decreased marginally from 4.7 (3.8–5.2) on day 1 to 3.8 (3.0–4.6) on day 29 (P〈0.03). There was no difference in median intragastric pH during 24-hr, day and night periods before and two days after ranitidine dosing. No significant tolerance or rebound to H2-receptor antagonists was observed in patients with duodenal ulcer disease. This contrasts with data gathered in healthy volunteers and may be due to defects in the regulation of acid secretion in duodenal ulcer disease.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1573-2568
    Keywords: peptic ulcer ; gastric acidity ; pH monitoring ; smoking
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The influence of cigarette smoking on intragastric acidity was assessed in duodenal ulcer patients in symptomatic remission and in healthy volunteers in a retrospective study. Continuous 24-hr pH recordings in 150 nonsmokers and 174 smokers receiving placebo treatment were compared. Daytime intragastric acidity was higher in smokers with a median pH (interquartile range) of 1.56 (1.34–1.80) than in nonsmokers, who had a median pH of 1.70 (1.45–1.97) (P〈0.001). There was no difference in 24-hr and nighttime median pH between the two groups. The small difference in daytime intragastric acidity in smokers and nonsmokers is unlikely to account for the increased prevalence of peptic ulcer disease in smokers. The analysis of smoking status in duodenal ulcer patients and healthy controls and males and females supports the general trend towards higher daytime acidity in smokers. Again, no differences in pH during the 24-hr or night period were found between the groups. The epidemiological and clinical correlation between smoking and duodenal ulcer disease is not adequately explained by increased intragastric acidity.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    Digestive diseases and sciences 38 (1993), S. 2087-2089 
    ISSN: 1573-2568
    Keywords: Gastrospirillum hominis ; healthy subjects ; gastritis ; Helicobacter pylori ; prevalence
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Gastrospirillum hominis is a spiral-shaped bacterium found in the stomach. It has been implicated as a possible cause of chronic gastritis. We report two cases ofG. hominis colonization observed in a series of 175 healthy, asymptomatic volunteers investigated forHelicobacter pylori. None of the volunteers has symptoms or a history of gastrointestinal disease. Both carriers ofG. hominis had histological signs of chronic, active antral gastritis. Multiple tests forH. pylori were negative. The prevalence of this spiral bacterium in healthy, asymptomatic individuals may be as low as in symptomatic persons.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    Digestive diseases and sciences 35 (1990), S. 976-983 
    ISSN: 1573-2568
    Keywords: 24-hour pH-metry ; tolerance ; ranitidine ; famotidine ; acid inhibition ; pharmacodynamics ; H2-receptor antagonists
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The acid-inhibitory action of H2-receptor antagonists was shown to decrease after one to two weeks of dosing in healthy volunteers. This tolerance was evaluated in three randomized, placebo-controlled trials with the H2-receptor antagonists famotidine, 40 mg given after the evening meal for 28 days; ranitidine, 300 mg four times a day for seven days followed by 300 mg at night until day 28; and ranitidine, 300 mg three times a day vs 300 mg at night for 14 days. Continuous 24-hr pH monitoring with glass electrodes was performed under fed conditions. The median 24-hr pH decreased from 3.2 on day 1 with famotidine 40 mg to 1.9 on day 28 (P〈0.0012). After seven days of dosing with ranitidine 300 mg four times a day the median 24-hr pH dropped from 5.0 on day 1 to 3.0 on day 7 (P〈0.001) and then to 2.2 with ranitidine 300 mg at night on day 28. With ranitidine 300 mg three times a day the median 24-hr pH fell from 4.3 on day 1 to 2.4 on day 14 (P〈 0.0005). With ranitidine 300 mg at night the respective pH values were 2.5 and 1.8 (P〈 0.003). Tolerance to H2-receptor antagonists given in a single evening dose was only evident during the night, whereas tolerance occurred throughout the day and night with the three- and four-times-a-day regimens. A large increase in the interindividual variability of pH response was seen during the nighttime.
    Type of Medium: Electronic Resource
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