Chronic Pain Management and Arthritis
Deborah Fish Ragin in Health Psychology, 2017
Nonsteroidal Anti-Inflammation Drugs (NSAIDs) Aspirin is the mildest nonsteroidal anti-inflammatory drug (NSAIDs) available to control mild, arthritis-related symptoms of inflammation and pain. When taken in low doses, aspirin is a relatively safe medication. However, to relieve the inflammation and stiffness associated with arthritis, aspirin must be taken frequently and in high doses (Kunz, 1982), a dosing practice that can cause other health problems. Research has shown that aspirin in high doses causes disruptive effects on the urinary and digestive tract and can result in stomach ulcers. To understand the limitations of an aspirin regimen for arthritis, consider stomach ulcers. An ulcer is essentially a hole in the stomach’s lining. Ulcers present a problem because the hole allows the gastric juices from the stomach to irritate other body systems. If severe, the hole may not be repaired but only treated with medication and a restricted diet. Such a diet would exclude aspirin and other medications that similarly can irritate the stomach. Therefore, a high-dose aspirin therapy needed to control arthritis pain and inflammation has risky side effects, can limit the effective use of other medications, and must be used only with medical supervision.
Ulcers—Peptic/Gastroduodenal
Charles Theisler in Adjuvant Medical Care, 2023
If stomach acid burns through the protective mucus layer in the stomach, this causes the erosions or sores in the lining of the stomach and upper small intestine known as peptic ulcers. Peptic ulcers include gastric and duodenal ulcers. Peptic ulcers can be present even if there are no symptoms or if symptoms are mild, but can cause significant problems if left untreated. A dull, biting, gnawing, or burning pain in the upper abdomen is the most common symptom of a peptic ulcer. Additional symptoms may be bloating, gas, indigestion, and nausea. Abdominal pain is often worse at night or in between meals when the stomach is empty. The pain can often be briefly ameliorated by eating or taking antacids. Peptic ulcers can lead to internal bleeding. The most common causes of peptic ulcers are Helicobacter pylori (H. pylori) infection, excess stomach acid, and long-term use of aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs, e.g., Motrin, Advil, Aleve, etc.). The goals of therapy are to: (1) resolve symptoms; (2) reduce acid secretion; (3) promote epithelial healing; (4) prevent ulcer-related complications; and (5) prevent ulcer recurrence.
Digestive and Metabolic Actions of Dopamine
Nira Ben-Jonathan in Dopamine, 2020
The stomach walls are lined by a thick layer of mucus that prevents the stomach from digesting itself by the hydrochloric acid. When mucus is limited, an ulcer (erosion of tissue) may form. Peptic ulcers are open sores that develop on the inner lining of the stomach or duodenum. They affect as many as 5%–10% of people in Western societies, cause pain and indigestion, and can be transiently alleviated by antacid medications. The two main causes for gastric ulcers are long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen and an infection with a specific bacterium, Helicobacter pylori [33]. H. pylori infection is a key factor in the etiology of various GI diseases, ranging from chronic active gastritis without clinical symptoms, to peptic ulceration, gastric adenocarcinoma, and gastric mucosa-associated lymphoid tissue lymphoma. Disease outcome is the result of a complex interplay between the host and the bacterium. Host immune gene polymorphisms and gastric acid secretion largely determine the bacterium’s ability to colonize and act upon a specific gastric niche [34].
Protective effect of the solvent extracts of Portulacca oleracea against acidified ethanol induced gastric ulcer in rabbits
Published in Drug and Chemical Toxicology, 2022
Muhammad Shah Zeb Jan, Waqar Ahmad, Atif Kamil, Mir Azam Khan, Maqsood Ur Rehman, Irfan ullah, Muhammad Saeed Jan
Ulcer is an injury or sore in the mucous membrane or outer surface skin of the body. Ulcer in the lining of the stomach or duodenum is a disease of digestive system that affect many people around the world (Sánchez-Mendoza et al.2011). It has been documented that fourteen million people throughout the world are suffering from gastric ulcer with a mortality rate of four million. Gastric ulcer occur as a result of imbalance between aggressive (alcohol, pepsin and acid secretion, poor diet, oxidative stress, NSAIDs and Helicobacter pylori) and protective factors (mucosal blood flow, mucus secretion, bicarbonate secretion and increased levels of antioxidants etc.) in the stomach (Zakaria et al.2016b). Gastric mucosa is damaged when aggressive factors “overcome” mucosal defensive mechanisms (Laine et al.2008).
Management of Citrus sinensis peels for protection and treatment against gastric ulcer induced by ethanol in rats
Published in Biomarkers, 2020
Asmaa Aboul Naser, Eman Younis, Amal El-Feky, Marwa Elbatanony, Manal Hamed
Stomach ulcer is one of the most common gastrointestinal disorders. It affected people of all ages around the world. Its harmful effect resulted from the disturbance between the endogenous offensive factors like hydrochloric acid, pepsin, reactive oxygen species and the defensive agents like mucosal bicarbonate barrier, prostaglandin E2, cell renewal and antioxidant markers (Farzaei et al. 2015). This disrupted equilibrium is mainly due to the excessive exposure of the gastric mucosa to non-steroid anti-inflammatory drugs, smoking, nutritional deficiencies, stress and ingestion of ethanol (Spirt 2004). Ethanol ingestion increases the gastric mucosa permeability, hydrogen ions leakage from the lumen and hydrochloric acid diffusion (Xie et al. 2013). Additionally, ethanol gastric mucosal damage develops an increase in some cyclooxygenase enzymes, cytokines, free radicals and signalling molecules that leads to inflammation and apoptosis (Wang et al. 2015). Moreover, ethanol intake leads to a state of intracellular oxidative stress with continuous generation of free radicals that affect the DNA of mucosal cells leading to gastric cancer (Fox and Wang 2007).
Long-term safety and effectiveness of vonoprazan for prevention of gastric and duodenal ulcer recurrence in patients on nonsteroidal anti-inflammatory drugs in Japan: a 12-month post-marketing surveillance study
Published in Expert Opinion on Drug Safety, 2023
Takashi Kawai, Chihiro Suzuki, Youichirou Honda, Jovelle L. Fernandez
All data were entered into a web-based electronic data capture system by the surveillance investigator. Collected information included: (i) patient demographics and medical history, including self-reported H. pylori infection; (ii) concurrent medical conditions and treatments including the date of initiation, reason for use, dosage, and administration of vonoprazan, NSAIDs, and any concomitant medications; (iii) assessments for gastric/duodenal ulcer or hemorrhagic lesions, including the date of endoscopy (if performed, as it was not mandatory; ulcer sizes were not confirmed and the presence of ‘bleeding’ was based on the physician’s judgment) or diagnosis; and (iv) liver function tests and assessment of serum gastrin. For safety, the following information was collected: presence or absence of adverse events (AEs) during the observation period, including terms used, date of onset, seriousness, reason for seriousness, causal relationship to vonoprazan, and reason for discontinuation of vonoprazan if related to safety. Any AE that was reported after initiation of vonoprazan and for which vonoprazan could not be ruled out as the cause was defined as an adverse drug reaction (ADR). Hospitalization was regarded as a serious AE and was reported as such. Data on adherence to medications were not collected.
Related Knowledge Centers
- Anal Fissure
- Aphthous Stomatitis
- Corneal Ulcer
- Diabetic Foot Ulcer
- Genital Ulcer
- Mouth Ulcer
- Pressure Ulcer
- Ulcer
- Ulcerative Dermatitis
- Callous Ulcer