scholarly journals Proton Pump Inhibitor-Related Gastric Mucosal Changes

Gut and Liver ◽  
2020 ◽  
Author(s):  
Gwang Ha Kim
Keyword(s):  
Proton Pump Inhibitor ◽  
Proton Pump ◽  
Mucosal Changes ◽  
Gastric Mucosal Changes

PORTAL HYPERTENSIVE GASTROPATHY: A COMPREHENSIVE REVIEW

2020 ◽  
Vol 4 (4) ◽  
Author(s):  
Shabir Shiekh ◽  
Showkat Kadla ◽  
Bilal Khan ◽  
Nisar Shah
Keyword(s):  
Gastrointestinal Bleeding ◽  
Beta Blockers ◽  
Secondary Prophylaxis ◽  
Deficiency Anemia ◽  
Portal Hypertensive Gastropathy ◽  
Shunt Surgery ◽  
Comprehensive Review ◽  
Mucosal Changes ◽  
Gi Bleed ◽  
Gastric Mucosal Changes

Portal hypertensive gastropathy (PHG) encompasses the gastric mucosal changes occurring in the setting of portal hypertension,both cirrhotic and non-cirrhotic. Its significance lies in causing acute gastrointestinal bleeding and insidious chronic blood loss presenting as iron deficiency anemia. Diagnosis of PHG is straight-forward, made endoscopically often characterized by  a mosaic-like pattern resembling ‘snake-skin’, with or without red spots. Treatment of acute GI bleed is hemodynamic stabilization, vasoconstrictor therapy, antibiotic prophylaxis, non-selective beta-blockers. Endoscopic treatment like APC has a small role. In severe cases, TIPS and shunt surgery can be offered. Secondary prophylaxis of PHG bleeding with non-selective b-blockers is recommended. Keywords: Portal hypertension­, Gastrointestinal bleeding, Cirrhosis, Beta-blockers

Duodenal Ulcer Induced by Hem-o-Lok clip after Reduced Port Laparoscopic Cholecystectomy

2016 ◽  
Vol 25 (1) ◽  
pp. 95-98 ◽  
Author(s):  
Koichi Soga ◽  
Kyoichi Kassai ◽  
Kenji Itani
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Proton Pump Inhibitor ◽  
Proton Pump ◽  
Cystic Duct ◽  
Duodenal Bulb ◽  
Mucosal Injury ◽  
Normal Mucosa ◽  
Surrounding Tissue ◽  
Inferior Wall ◽  
Endoscopic Clip

The patient was a 66-year-old woman who had undergone laparoscopic cholecystectomy (Lap-C) secondary to chronic cholecystitis status post endoscopic choledocholithotomy 13 months previously. During surgery, Hem-o-Lok clips were used to control the cystic duct and the cystic artery. Due to the presence of extensive adhesions of the cystic duct and surrounding tissue, the surgeons had difficulty in debriding the area. Thirteen months after Lap-C, the patient underwent a screening esophagogastroduodenoscopy (EGD), which demonstrated clip appearance at the inferior wall of the first part of the duodenum. In the EGD, duodenal erosions and edema were observed around the clip. We appreciated that endoscopic clip removal would be difficult because of the presence of severe adhesions and inflammation of the duodenal bulb. On clinical examination of the patient, no major abnormalities or physical findings were noted. Therefore, we decided not to attempt to remove the clip. The patient was treated with an oral proton pump inhibitor to prevent extensive duodenal mucosal injury. Two months later, we repeated the EGD, which revealed that the clip was no longer present, and the duodenum was covered with normal mucosa surrounding the scar. Abbreviations: EGD: esophagogastroduodenoscopy; Lap-C: laparoscopic cholecystectomy; PPI: proton pump inhibitor.

Potential reasons for proton pump inhibitor failure in the treatment of gastroesophageal reflux disease

2008 ◽  
Vol 149 (40) ◽  
pp. 1881-1888 ◽  
Author(s):  
Márk Juhász ◽  
Zsolt Tulassay
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Proton Pump Inhibitor ◽  
Gastroesophageal Reflux ◽  
Proton Pump ◽  
Reflux Disease

A protonpumpagátlók (protonpumpa-inhibitorok, PPI) bevezetése új fejezetet nyitott a gastrooesophagealis refluxbetegség (gastroesophageal reflux disease, GERD) kezelésében. A betegek kisebb, de nem jelentéktelen hányadában azonban a PPI sem hatékony. Ilyen esetekben az első kérdés mindig az, hogy a tünetek valóban GERD-nek tulajdoníthatók-e, vagy egyéb betegség után kell kutatnunk. Ha a GERD a legvalószínűbb lehetőség, akkor a további vizsgálatok és a több támadáspontú kezelés előtt fel kell térképeznünk a beteg együttműködését (compliance). Ha az eredménytelen PPI-kezelés hátterében nem helytelenül kezelt GERD áll, akkor számos egyéb kórkép lehetőségét is fel kell vetnünk. Összefoglaló közleményünkben az elkülönítő diagnosztikai kérdésekről adunk áttekintést.

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