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Amalaki
Published in H.S. Puri, Rasayana, 2002
Cases of hyperchlorhydria with burning sensation in the abdomen, cardiac and gastric regions benefited from application of the fruit powder. A decoction prepared by taking 5 g amla in 80 ml of water (reduced to 20 ml) was given after main meals to patients. There was significant relief in symptoms after 30 days (Tripathi et al. 1992). When water extract of amla was administered to patients of hyperhidrosis, excellent results were achieved in 29 of 40 cases (Zachariah, 1984).
Surgical management of pancreatic neuroendocrine tumors: an introduction
Published in Expert Review of Anticancer Therapy, 2019
Elisabeth Hain, Rémy Sindayigaya, Jade Fawaz, Joseph Gharios, Gaspard Bouteloup, Philippe Soyer, Jérôme Bertherat, Frédéric Prat, Benoit Terris, Romain Coriat, Sébastien Gaujoux
The diagnosis of gastrinomas is based on the association of hypergastrinemia/hyperchlorhydria associated with severe peptic ulceration with profuse diarrhea (Zollinger-Ellison syndrome) [17,26]. The first and urgent treatment of gastrinomas must be to control the hormonal hypersecretion with proton-pump inhibitors, sometimes at high doses. These tumors are frequently small, multiple even if sporadic and localized in the Stabile and Passaro triangle (Figure 3). Within this triangle, they are more frequently located in the duodenum. This location is associated with a better prognosis [27]. In general, it is very difficult to determine the exact location of a gastrinoma preoperatively because of the small size and multiplicity of the lesion. It requires CT, EUS and a fibroscopy/duodenoscopy, in addition to somatostatin receptor imaging. 68Gallium-DOTATATE/TOC PET/CT seems to be more accurate and sensitive for detecting pNET and gastrinoma compared to 111In-pentetreotide SPECT/CT and CT [28]. For sporadic gastrinoma, surgery (either local excision or pancreaticoduodenectomy) with formal lymphadenectomy is required and is associated with patient overall survival [29,30]. For MEN-1-related gastrinomas, surgery is controversial [26,31] and usually limited to tumors > 2 cm [32].
The gut–brain axis: historical reflections
Published in Microbial Ecology in Health and Disease, 2018
In 1951, one patient, John Parr, published a short book entitled How I Cured my Duodenal Ulcer. In this, Parr recounted that when he first developed an ulcer, medicines failed to work and X-Rays found no evidence of illness. Parr was informed that he was suffering from hyperchlorhydria which he described as ‘a tiresomely long word to describe a condition of too much anxiety’. Surgeons then performed an operation, but no ulcer was found. A diet was imposed of milk, orange juice and steamed fish but the pains returned. In a chapter entitled ‘Disillusioned’, Parr mentioned that despite being informed that he could not be cured ‘it was impressed upon me that I was on no account to worry, because worry was a primary cause of ulceration’. Ten years later, Parr began to lose faith in doctors. It was only when he went to fight in the Second World War that a detectable ulcer finally developed. A further decade later, he wrote: I had now suffered, intermittently but increasingly, for over 20 years. During that time, I had been to as many doctors and had tried countless remedies. I had been advised to take exercise and to rest; to live on little else but eggs and milk; to drink only before meals; to give up smoking and alcohol; to stop worrying; to eat slowly and chew my food thoroughly; I had had one abortive operation and had been advised to have another. I had had one X-Ray after another. I had swallowed innumerable gallons of medicines.
The interplay between Helicobacter pylori and gastrointestinal microbiota
Published in Gut Microbes, 2021
Chieh-Chang Chen, Jyh-Ming Liou, Yi-Chia Lee, Tzu-Chan Hong, Emad M El-Omar, Ming-Shiang Wu
As a GI tract microbe, Helicobacter pylori is one of the most-studied bacteria. It is highly adapted to the human gastric mucosa and thrives in the stomach niche, having co-evolved with humans over tens of thousands of years.4 Chronic infection can lead to either hypo- or hyperchlorhydria, depending on the anatomic distribution and severity of the resulting inflammation.5 Although the majority of H. pylori–infected persons remain asymptomatic, chronic infection has been linked to peptic ulcer disease, gastric cancer, gastric mucosa-associated lymphoid tissue lymphoma, and a multitude of extragastric diseases. Current studies suggest that eradication of H. pylori can effectively reduce gastric cancer incidence and treatment should be considered for all H. pylori–infected persons to reduce the risk of peptic ulcers and gastric cancers.6–8 However, there are still debates regarding the beneficial effects of H. pylori colonization, including regression in childhood asthma and other atopic disorders.9,10 It has been concluded that H. pylori is a common flora, or at least a harmless bacterium. Additionally, the mass eradication of H. pylori with antibiotic treatment as a preventive measure for gastric cancer and peptic ulcers raises several concerns, including the emergence of antibiotic resistance and perturbations in gut microbiota following H. pylori eradication.11,12 Being part of the GI ecosystem, H. pylori infection and its impact on gastric acid secretion may alter the GI microbiome and host health status. Here, we review current understandings of the impact of H. pylori infection on the GI microbiome and how it influences human health.