Factors predicting failure of medical therapy for gastric ulcers

Article Abstract:

The medical treatment of gastric (stomach) ulcers has improved over the last 20 years. It has been shown that treatment with medications has deceased the number of patients requiring surgery, but this has not changed the rate of ulcer recurrence and has actually increased the proportion of patients requiring emergency surgery. The overall results of treatment would be improved if patients who would eventually require surgery could be identified and could then undergo elective surgery. A review was undertaken of the medical records of 134 patients treated between 1970 and 1980 for gastric ulcers to determine if any factors were associated with failure of medical treatment (use of medications). There were 100 patients successfully treated medically, but 34 patients required surgery. Antacids were the primary therapy for 78 percent of patients, and the remaining 22 percent were treated with both H2 blockers (anti-ulcer drugs) and antacids. Medical therapy was continued for an average of 46.3 months; however, those patients who eventually underwent surgery received medical treatment for an average of 14.7 months. Fifteen of the 34 surgical patients had emergency operations. Mortality was 33 percent among patients who underwent emergency surgery and 10 percent among those who underwent elective surgery. Several significant risk factors were identified in those patients requiring surgery: smoking; multiple trauma and sepsis; large ulcers; and multiple ulcers. It is suggested that patients with these risk factors be treated with a limited trial of medical therapy; if they do not respond, they should be considered for elective surgery. (Consumer Summary produced by Reliance Medical Information, Inc.)

Drug therapy, Stomach ulcer

---

Long-term studies of mental health after the Greenville gastric bypass operation for morbid obesity

Article Abstract:

For morbidly obese people (individuals more than 100 pounds over their ideal weight), the only consistently effective method of weight control appears to be surgery. Morbid obesity has been associated with depression, anxiety, and low self-esteem. The Greenville gastric bypass is a technique that has been shown to be a most effective bariatric (weight loss) surgical procedure. Results are reported of 462 patients who underwent the Greenville gastric bypass between February 1980 and May 1989. The most recent 157 patients were evaluated for mental, as well as physical, function following surgery. The procedure was found to be effective in maintaining weight loss. The average preoperative weight was 293 pounds; at two years it was 179 pounds, and at eight years it was 190 pounds. The surgery had a beneficial effect on noninsulin dependent diabetes mellitus and high blood pressure. A mental health questionnaire, designed to measure anxiety, depression, positive well-being and self-control, vitality and general health was administered to the subjects before surgery, and four more times, up to three years after surgery. Initial improvements in psychological factors were seen at 6 and at 12 months after surgery. However, at the end of two years, the psychological status of the subjects was comparable to the status measured before surgery. In the total population (462) there were three suicides and two deaths due to alcohol abuse. The results suggest that long-term follow-up and continued emotional support are important in achieving good results after bariatric surgery. (Consumer Summary produced by Reliance Medical Information, Inc.)

Psychological aspects, Prognosis, Overweight persons, Obesity, Gastric bypass

---

Gastric emptying and bezoars

Article Abstract:

Bezoars, balls of undigested material in the cavity of the stomach or intestine, sometimes occur as a late complication of stomach surgery and are presumably related to a drop in the ability of the gut to move spontaneously (for instance, to digest food). The authors studied two groups: one group who had undergone gut surgery and had bezoar and another group who had similar surgery without the formation of bezoar. Both groups were fed a radioactively labeled meal to study how quickly the food passed through the gut. The investigators found no difference between the groups and concluded that factors other than the digestive stage that occurs in the stomach are related to bezoar formation.

Causes of, Physiological aspects, Digestion, Bezoar, Gastrostomy, Bezoars

Similar abstracts:

• Abstracts: Factors influencing the outcome of congenital heart disease detected prenatally
• Abstracts: Autoimmunity after alpha-interferon therapy for malignant carcinoid tumors. Acquired C1 Esterase Inhibitor Deficiency
• Abstracts: Limitations of listing specific medical interventions in advance directives. Advance Directives for Nursing Home Residents: Achieving Compassionate, Competent, Cost-effective Care
• Abstracts: Changing patterns of medical practice: protein restriction for chronic renal failure
• Abstracts: The changing face of infectious disease: New threats, new science. Leukemia: steady progress brightens outlook on blood disease

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.