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Pyrosis
Pyrosis
or other organic acid fermentation. Occurring later, during activedigestion, it may be due to the same cause or to hyperacidity from excess of hydrochloric acid. The latter condition is less common when due to lactic acid; the giving of hydrochloric acid stops further fermentation, whereas sodium bicarbonate, although it momentarily neutralises the lactic acid, soon produces analkalinereaction in which the further development of the acid rapidly proceeds. On the other hand, pyrosis due to hydrochloric acid must be checked by alkalies. http://chestofbooks.com/health/nutrition/Dietetics-4/Abnormalities-Of-Gastric-Digestion.html#.UUbsZBdTDqC
Objective To observe clinical efficacy of Huazhuo Jiedu Recipe(HJR) on chronic atrophic gastritic precancerosis(CAGP),and its effect on contents of lactic acid,total acid,free acid,and nitrite in the gastric juice,as well as tumor markers in gastric juice and blood.Methods Two hundred and twenty-nine patients with CAGP were randomly assigned to two groups,the 119 patients in the treated group orally took HJR and the 110 patients in the control group orally took Weifuchun Tablet.The therapeutic course for all was three months,two courses in total.The therapeutic efficacy,changes of gastric acid contents before and after treatment were observed,and the tumor markers in the gastric juice and blood were detected using electrochemical luminescence immunoassay.Results The pathological effective rate was 83.2%(99/119) in the treated group and 60.9%(67/110) in the control group,showing significant difference between the two groups(P0.05).The total acids and free acids in the gastric juice were significantly improved,contents of lactic acid and nitrite were significantly lowered in the two groups.Both contents of carcinoembryonic antigen(CEA),carbohydrate antigen19-9(CA19-9),carbohydrate antigen72-4(CA72-4),and carbohydrate antigen125(CA125) in the gastric juice and serum were significantly lowered after treatment in the treated group(P0.05).Compared with the normal control group,the therapeutic effect was more obvious in the treated group(P0.05).ConclusionsHJR could stimulate the gastric membranous secretion,enhance contents of total acids and free acids.It could prevent the further progress of CAGP by decreasing contents of lactic acid and nitrite in the gastric juice,and lowering contents of CEA,CA19-9,CA72-4,and CA125 in the gastric juice and serum.
http://en.cnki.com.cn/Article_en/CJFDTOTAL-ZZXJ201104026.htm
se crede ca acidul lactic este secretat de mucoasa gastrica in carcinomul de stomac http://books.google.ro/books?id=LKy0weDEFp8C&pg=PA616&lpg=PA616&dq=lactic+acid+in+gastric+jui ce&source=bl&ots=4ZubBw2L2S&sig=qgwRp4XKxUSQ2XIHLLxLwNYvHI&hl=ro&sa=X&ei=lPhCUZnOIcTvOsfogOAB&sqi=2&ved=0CJIBEOgBMAk#v=onepage&q=l actic%20acid%20in%20gastric%20juice&f=false
Cele stimulente convenionale ale secretiei gastrice (histamina, pentagastrina, i insulina), rezultat dintro scdere a concentraiei de acid lactic i, de obicei, o cretere a produciei de acid lactic. De ageni care impun, direct sau indirect o sarcin de acid lactic (glucoz, fructoz, xilitol, epinefrina) conduce, de obicei, la o cretere a concentraiei de acid lactic i de ieire. Se consider c non-ionic difuzie joac un rol mic n secreia de acid lactic, precum i faptul c coninutul de acid lactic al sucului gastric reflect procesele metabolice in celulele mucoasei gastrice.
http://www.deepdyve.com/lp/informa-healthcare/lactic-acid-in-gastric-juice5ScRqi71PH?articleList=%2Fsearch%3Fquery%3Dlactic%2Bacid%2Bin%2Bgastric%2Bjuice
http://books.google.ro/books?id=NJNYKeftqYQC&pg=RA8-PA50&lpg=RA8PA50&dq=lactic+acid+in+gastric+juice&source=bl&ots=5qmSSVpJzi&sig=y8nZ-vQMtFbnOQhKx9pO8kyxrM&hl=ro&sa=X&ei=h_9CUcvOFIaHPYbwgdgC&ved=0CDMQ6AEwATge#v=onepage&q&f=false
Pirozis, eructaii sau de gaz din stomac, n cazul n care acesta se produce foarte scurt timp dup ingestia de alimente, este de obicei din cauza fermentare lactic sau de alt natur acid organic. Apar mai tarziu, in timpul digestiei activ, aceasta poate fi din cauza aceleiai cauze sau pentru a hiperaciditate de la excesul de acid clorhidric.Aceast din urm condiie este mai puin frecvente atunci cnd se datoreaz n acid lactic, oferind de acid clorhidric se oprete fermentare n continuare, ntruct bicarbonat de sodiu, dei acesta neutralizeaz acidul lactic momentan, produce n curnd analkalinereaction n care dezvoltarea n continuare a acidului rapid veniturile. Pe de alt parte, pirozisul din cauza acidului clorhidric trebuie s fie verificate de substane alcaline.
Pentru a observa eficacitatea clinic a Huazhuo Jiedu Reet (HJR) pe precancerosis cronic atrofic gastritic (CAGP), precum i efectul su asupra coninutului de acid lactic, acid total, acid liber, i nitrii n sucul gastric, precum i markeri tumorali n gastrice suc i blood.Methods Dou sute i douzeci i nou pacieni cu CAGP au fost repartizati aleatoriu in doua grupuri, cei 119 pacienti din grupul tratat a luat pe cale oral HJR i de 110 pacieni din grupul de control au luat pe cale oral Weifuchun curs terapeutic Tablet.The pentru toi a fost de trei luni, dou cursuri n eficacitatea terapeutic total.The, modificri ale coninutului de acid gastric, nainte i dup tratament s-au observat, iar markerii tumorali n sucul gastric i snge au fost detectate cu ajutorul electrochimice iluminare immunoassay.Results rata efectiv a fost de patologic 83,2% (99/119) n grupul tratat i 60,9% (67/110) n grupul de control, care arat o diferen semnificativ ntre cele dou grupuri (P0.05). acizii totale i acizi liberi n sucul gastric au fost semnificativ mbuntite, coninutul de acid lactic i nitrii au fost semnificativ redus n coninutul groups.Both dou dintre antigen carcinoembrionar (CEA), glucide antigen19-9 (CA19-9), glucide
antigen72-4 (CA72-4), i carbohidrai antigen125 (CA125), n gastric suc i ser au fost semnificativ redus dup tratament, n grupul tratat (P0.05). Comparativ cu grupul de control normale, efectul terapeutic a fost mai evident n grupul tratat (P0.05). ConclusionsHJR ar putea stimula secreia gastric membranoas, sporirea Coninutul de acizi totale si acids.It liber ar putea mpiedica progresul n continuare a CAGP prin scderea coninutului de acid lactic i nitrii n sucul gastric, i reducerea coninutului de CEA, CA19-9, CA72-4, i CA125 n sucul gastric i ser.
OBJECTIVE: To observe clinical efficacy of Huazhuo Jiedu Recipe (HJR) on chronic atrophic gastritic precancerosis (CAGP), and its effect on contents of lactic acid, total acid, free acid, and nitrite in the gastric juice, as well as tumor markers in gastric juice and blood. METHODS: Two hundred and twenty-nine patients with CAGP were randomly assigned to two groups, the 119 patients in the treated group orally took HJR and the 110 patients in the control group orally took Weifuchun Tablet. The therapeutic course for all was three months, two courses in total. The therapeutic efficacy, changes of gastric acid contents before and after treatment were observed, and the tumor markers in the gastric juice and blood were detected using electrochemical luminescence immunoassay. RESULTS: The pathological effective rate was 83.2% (99/119) in the treated group and 60.9% (67/110) in the control group, showing significant difference between the two groups (P <0.05). The total acids and free acids in the gastric juice were significantly improved, contents of lactic acid and nitrite were significantly lowered in the two groups. Both contents of carcinoembryonic antigen (CEA), carbohydrate antigen19-9 (CA19-9), carbohydrate antigen72-4 (CA724), and carbohydrate antigen125 (CA125) in the gastric juice and serum were significantly lowered after treatment in the treated group (P<0.05). Compared with the normal control group, the therapeutic effect was more obvious in the treated group (P<0.05). CONCLUSIONS: HJR could stimulate the gastric membranous secretion, enhance contents of total acids and free acids. It could prevent the further progress of CAGP by decreasing contents of lactic acid and nitrite in the gastric juice, and lowering contents of CEA, CA19-9, CA72-4, and CA125 in the gastric juice and serum.
CANCERUL GASTRIC
Cancerul gastric reprezint pentru Romania o problema important, avand in vedere frecvena lui inc mare. Neoplasmul gastric reprezint in lume o cauz important de mortalitate prin cancer .
Epidemiologie
Frecvena acestui cancer difer destul de mult dup ariile geografice, fiind in legtur direct cu obiceiurile alimentare (in Japonia frecvena este deosebit de mare). In Europa, este mai frecvent in zonele nordice, tot in legtur cu obiceiurile alimentare (conservarea alimentelor). Acest cancer este de 2-3 ori mai frecvent la brbat decat la femeie, iar frecvena crete cu varsta (varsta medie la diagnostic este de peste 60 de ani). Apare rareori sub varsta de 45 de ani. Frecvena acestui cancer a inceput s scad in ultimul deceniu, odat cu eradicarea tot mai frecvent a HP.
Etiopatogenie
In ultimul timp a fost tot mai bine stabilit relaia dintre infecia cu Helicobacter Pilory (HP) i cancerul gastric. OMS consider HP ca oncogen de rangul I . Faptul c de peste un deceniu s-a trecut la eradicarea acestei infecii a fcut ca in lume tendina in ultimul timp s fie de scdere a incidenei acestui cancer (lucru mai vizibil in rile avansate socio-economic). Factorii de risc pentru cancer gastric sunt reprezentai de: obiceiurile alimentare: coninutul crescut de nitrozamine din alimentele conservate prin sare i fum, sunt factori favorizani pentru neoplasm gastric; in schimb, alimentaia bogat in fructe i legume cu coninut de vitamine C i A, protejeaz stomacul. factorul genetic: existena unei predispoziii familiale pentru acest tip de neoplasm. standardul economico-social sczut poate fi un factor favorizant, probabil prin alimentaie, infecie HP etc. infecia cu Helicobacter Pylori: este tot mai mult demonstrat ca participand la etiopatogeneza neoplasmului gastric. HP a fost incadrat recent, de OMS, drept carcinogen de ordinul I, recunoscandu-i-se astfel implicarea in etiopatogenia acestui neoplasm. Intervenia Hp se realizeaz prin inducerea gastritei atrofice cu metaplazie intestinal, ceea ce reprezint un potenial evolutiv spre displazie i neoplazie. Afeciunile gastrice predispozante pentru cancer gastric sunt: gastrita cronic atrofic: cel mai adesea in legtura cu infecia Hp; pe acest fond apar adesea leziuni displazice, care evolueaz de la displazie uoar la sever (aceasta din urm considerat de fapt un adevrat cancer intra-epitelial). polipii adenomatoi gastrici rezecia gastric ulcerul gastric reprezint un risc mic de malignizare, cel mai adesea poate fi vorba de confuzie diagnostic endoscopic, unele neoplasme putand avea i ele perioade de epitelizare ( cancer ulcerat). Exist obligativitatea ca la fiecare endoscopie s se biopsieze multiplu fiecare ulcer gastric i de asemenea ca vindecarea ulcerului gastric s fie verificat endoscopic (cu biopsie din cicatrice). De reinut posibilitatea existentei unor cancere ulcerate, susceptibile de cicatrizare sub tratament medical.
Prognostic
Prognosticul cancerului gastric depinde de extensia TNM, de tipul histologic (slab sau bine difereniat), de varsta pacientului. Supravieuirea este foarte bun doar in cancerele superficiale (95% la 5 ani). Operabilitatea cu intenie de radicalitate a cancerului gastric se poate realiza doar la 1/3 din cazuri, iar la acetia supravieuirea la 5 ani este de aprox.25%.
Tratament
A. Chirurgical. Tratamentul de elecie i radical al cancerului gastric este chirurgia. Se realizeaz gastrectomia cu limfadenectomie. De obicei, se realizeaz o gastrectomie subtotal sau total (cu esojejunostomie), depinzand de localizarea i extensia tumoral. B. Endoscopic. Cancerele depite chirurgical pot eventual beneficia de un tratament endoscopic hemostatic cu argon Beamer (APC) sau aplicarea unor proteze endoscopice, in neoplasmele stenozante (cu rol paleativ). De asemeni, se poate practica mucosectomia endoscopic la formele de cancer gastric incipient in situ (ce prind doar mucoasa). Aceasta const in injectarea de ser fiziologic sub leziunea neoplazic
i transformarea ei intr-un pseudopolip sesil, care apoi va fi efectiv polipectomizat. Piesa rezecat endoscopic va fi examinat morfopatologic in totalitate, pentru a se vedea dac rezecia a fost radical. C. Chimioterapia. Chimioterapia postchirurgical este de obiceiindicat, mai ales in formele mai avansate, i cuprinde mai multe cure de adriamicin cu 5-FU. In general ins prognosticul cancerului gastric rmane rezervat. De aceea, se incearc gsirea unor protocoale de descoperire precoce a cancerului gastric, de indeprtare endoscopic a leziunilor precanceroase (polipi gastrici), de urmrire endoscopic periodic a stomacului operat (dup 15 ani de la rezecie). O problem mai spinoas este aceea a infeciei cu Helicobacter Pylori, carcinogen de ordinul I (dup OMS) pentru neoplasmul gastric. Se pune problema eradicrii acestei bacterii la unele categorii de pacieni (Consensul de la Maastricht), inclusiv la descendenii pacienilor cu neoplasm gastric sau la pacienii cu rezecii gastrice anterioare. Dezvoltarea in viitor a unui vaccin impotriva HP va rezolva probabil multe din problemele legate de cancerul gastric.