The Development of a New Proton-Pump Inhibitor: The Case History of Pantoprazole

2006 ◽  
pp. 115-136 ◽  
Author(s):  
Jörg Senn-Bilfinger ◽  
Ernst Sturm
Keyword(s):  
Proton Pump Inhibitor ◽  
Proton Pump ◽  
Case History ◽  
History Of

scholarly journals A141 SPONTANEOUS ESOPHAGEAL PERFORATION: AN UNREPORTED COMPLICATION OF LYMPHOCYTIC ESOPHAGITIS

2021 ◽  
Vol 4 (Supplement_1) ◽  
pp. 128-129
Author(s):  
A LAGROTTERIA ◽  
A W Collins ◽  
A Someili ◽  
N Narula
Keyword(s):  
Computed Tomography ◽  
Emergency Department ◽  
Case Report ◽  
Proton Pump Inhibitor ◽  
Proton Pump ◽  
Esophageal Perforation ◽  
Distal Esophagus ◽  
Chest Discomfort ◽  
History Of ◽  
Lymphocytic Esophagitis

Abstract Background Lymphocytic esophagitis is a new and rare clinicopathological entity. It is a histological pattern characterized by lymphocytic infiltrate without granulocytes. Its etiology and clinical significance remains unclear. The clinical manifestations are typically mild, with reflux and dysphagia the most commonly reported symptoms. Aims We describe a case report of spontaneous esophageal perforation associated with lymphocytic esophagitis. Methods Case report Results A previously well 31-year-old male presented to the emergency department with acute food impaction. His antecedent symptoms were acute chest discomfort and continuous odynophagia following his most recent meal, with persistent globus sensation. The patient had no reported history of allergies, atopy, rhinitis, or asthma. A previous history of non-progressive dysphagia was noted after resuscitation. Emergent endoscopy revealed no food bolus, but a deep 6 cm mucosal tear in the upper-mid esophagus extending 24 to 30 cm from the incisors. Chest computed tomography observed small volume pneumoperitoneum consistent with esophageal perforation. The patient’s recovery was uneventful; he was managed conservatively with broad-spectrum antibiotics, proton pump inhibitor therapy, and a soft-textured diet. Endoscopy was repeated 48 hours later and revealed considerable healing with only a residual 3-4cm linear laceration. Histology of biopsies taken from the mid and distal esophagus demonstrated marked infiltration of intraepithelial lymphocytes. There were no eosinophils or neutrophils identified, consistent with a diagnosis of lymphocytic esophagitis. Autoimmune indices including anti-nuclear antibodies and immunoglobulins were normal, ruling out a contributory autoimmune or connective tissue process. The patient was maintained on a proton pump inhibitor (pantoprazole 40 mg once daily) following discharge. Nearly six months following his presentation, the patient had a recurrence of symptoms prompting representation to the emergency department. He described acute onset chest discomfort while eating turkey. Computed tomography of the chest redemonstrated circumferential intramural gas in the distal esophagus and proximal stomach. Conclusions Esophageal perforation is a potentially life-threatening manifestation of what had been considered and described as a relatively benign condition. From isolated dysphagia to transmural perforation, this case significantly expands our current understanding of the clinical spectrum of lymphocytic esophagitis. Funding Agencies None

scholarly journals Pengaruh Penggunaan Proton Pump Inhibitor Jangka Panjang terhadap Sindrom Frailty pada Pasien Usia Lanjut

2016 ◽  
Vol 3 (3) ◽  
pp. 143
Author(s):  
Stephanie Dewi ◽  
Purwita W Laksmi ◽  
Ari Fahrial Syam ◽  
Esthika Dewiasty ◽  
Euphemia Seto
Keyword(s):  
Proton Pump Inhibitor ◽  
Proton Pump ◽  
Secondary Data ◽  
Health Condition ◽  
Cognitive Status ◽  
Primary Data ◽  
Frailty Syndrome ◽  
Frailty Status ◽  
History Of

Pendahuluan. Sindrom frailty berkaitan dengan angka morbiditas dan kematian yang lebih tinggi, sehingga dipakai sebagai prediktor kesehatan pada orang usia lanjut (usila). Polifarmasi sebagai salah satu faktor risiko sindrom frailty dapat berkaitan dengan obat Proton Pump Inhibitor (PPI) yang sering diberikan pada usila atas indikasi adanya keluhan gangguan saluran cerna bagian atas. Sampai saat ini belum ada penelitian yang mempelajari hubungan PPI jangka panjang dan sindrom frailty pada usila.Metode. Studi kasus kontrol pada pasien usila di Rumah Sakit dr. Cipto Mangunkusumo (RSCM), Jakarta. Kelompok kasus adalah usila terdiagnosis Frailty menurut FI-40 item dan kontrol adalah usila yang tidak frail berdasarkan instrumen yang sama. Data yang digunakan pada penelitian ini berasal dari data sekunder status frailty berdasarkan penelitian sebelumnya dan data rekam medis poliklinik Geriatri dan poliklinik diabetes RSCM.Hasil. Didapatkan 225 subjek (75 kasus: 150 kontrol), 59,6% berjenis kelamin perempuan (rerata usia 72,14 tahun; simpang baku ± 6,4 tathun) dan 47,1% berpendidikan tinggi. Subjek yang berpendidikan rendah, berstatus cerai mati, berstatus nutrisi lebih buruk, tidak mandiri, memerlukan caregiver, hidup tidak berkecukupan dan kondisi kesehatan yang lebih buruk lebih banyak didapatkan pada kelompok frail dibandingkan kelompok yang tidak frail. Proporsi pengguna PPI Jangka Panjang sebesar 40,9%. Penggunaan PPI jangka panjang meningkatkan risiko sindrom frailty (Crude OR 2,15; IK 95% 1,22- 3,78; p<0,007) dengan adjusted OR 1,83 (IK 1,0-3,36) terhadap variabel nutrisi dan merokok.Simpulan. Penggunaan PPI jangka panjang (≥ 6 bulan) secara independen meningkatkan salah satu risiko sindrom frailty pada usila.Kata Kunci: frailty, geriatri, proton pump inhibitor jangka panjang, usia lanjutThe Effect of Long-Term Proton Pump Inhibitor Use on Frailty Syndrome in Elderly PatientsIntroduction. Frailty syndrome, the newest elderly health predictor, associated with higher morbidity and mortality. PPI are often used in elderly due to presence of upper gastrointestinal complaints, and relates with polypharmacy as one of the risk factor for frailty syndrome. There is no study of the relationship between long term PPI use and frailty syndrome in elderly.Methods. A case control study included subjects 60 years and above with good cognitive status. All subjects with history of hypersensitivity of PPI were excluded. Elderly who were frail based on FI-40 item were defined as cases, while individuals that were not frail were classified as control. Primary data (included frailty status) was collected on March-June 2013 by Seto E and Sumantri S, et al. Secondary data used in this current study were gathered from the primary data of previous research and from the medical record taken from geriatric and diabetic outpatient clinics Cipto Mangunkusumo Hospital.Results. There were 225 subjects collected (75 cases: 150 controls), 59,6% were female (mean age 72,14 years old, SD ± 6,4 years) and 47,1% with higher education. Lower education, divorced, poor nutrition, dependent, needed caregiver, economically insufficient, more comorbidity and poor health condition were seen in frail group. The proportion of long term PPI use were 40,9%. Long term PPI medication increased the risk of frailty syndrome (Crude OR 2,154; CI 95% 1,225-3,778; p<0,007) with adjusted OR 1,83 (CI 95% 1,02-3,37) after adjusting with nutrition and smoking variables.Conclusions. Long term use of PPI significantly increase the risk of frailty syndrome compared to the non-users.

Small-bowel bacterial overgrowth

2010 ◽  
pp. 2330-2334
Author(s):  
Richard A. Schatz ◽  
Phillip P. Toskes
Keyword(s):  
Small Bowel ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Case History ◽  
Diagnostic Tool ◽  
Bacterial Overgrowth ◽  
Breath Tests ◽  
Small Bowel Bacterial Overgrowth ◽  
History Of

Case History—A 78 yr old woman presenting with a five-year history of diarrhoea. Updates Pathogenesis—discussion of the possible role of proton pump inhibitors. Diagnosis—comparison of lactulose hydrogen, glucose hydrogen, and 14C D-xylose breath tests; preliminary studies of circulating CdtB antibodies as a diagnostic tool....

scholarly journals The Effect of Proton Pump Inhibitor Use On Survival of Patients With Colorectal Cancer. A Study of a Racially Diverse Population

2021 ◽  
Author(s):  
Adham E Obeidat ◽  
Gabriel Monti ◽  
Horyun Choi ◽  
Jared Acoba
Keyword(s):  
Colorectal Cancer ◽  
Proton Pump Inhibitor ◽  
Retrospective Analysis ◽  
Proton Pump ◽  
P Value ◽  
Diverse Population ◽  
Racially Diverse ◽  
Prospective Data ◽  
Kaplan Meier ◽  
History Of

Abstract PurposeProton pump inhibitor (PPI) use is increasing in the general population. Chronic PPI use can lead to hypergastrinemia, which has been purported to increase the risk of developing colorectal cancer (CRC). Several studies have failed to report any association between PPI use and the risk of CRC. However, little is known about the effect of PPI use on CRC survival. In this retrospective analysis, we studied the effect of PPI use on CRC survival in a racially diverse population.MethodsData were abstracted for 1050 consecutive patients diagnosed with CRC from January 2007 to December 2020. Kaplan-Meier curve was created to study the effect of PPI exposure compared to no exposure on overall survival (OS). Univariate and multivariate analyses were performed to investigate predictors of survival.ResultsComplete data were available for 750 patients with CRC, 52.5% were males, 22.7% Whites, 60.1% Asians, and 17.2% Pacific-Islanders. 25.6% of patients had a history of PPI use. Moreover, 79.2% had hypertension, 68.8% had hyperlipidemia, 38.0% had diabetes mellitus and 30.2% had kidney disease.There was no difference in median OS among PPI users compared to non-users, p value= 0.4. Age, grade, and stage were predictors of inferior OS. No significant association was noticed with gender, race, comorbidities, or treatment with chemotherapy.ConclusionIn this retrospective analysis of a racially diverse population of CRC patients, we found that PPI use was not associated with worse OS. Until high quality prospective data are available, physicians should not stop PPIs that are clinically indicated.

Ex juvantibus approach for chronic posterior laryngitis: results of short-term pantoprazole therapy

1999 ◽  
Vol 113 (8) ◽  
pp. 734-739 ◽  
Author(s):  
Walter Habermann ◽  
Andreas Eherer ◽  
Franz Lindbichler ◽  
Johann Raith ◽  
Gerhard Friedrich
Keyword(s):  
Side Effects ◽  
Proton Pump ◽  
Case History ◽  
Therapeutic Option ◽  
Short Term ◽  
Globus Pharyngeus ◽  
Symptom Questionnaire ◽  
History Of ◽  
Pharyngeal Reflux

AbstractThe aim of this study was to investigate whether patients with chronic posterior laryngitis and symptoms of gastro-pharyngeal reflux benefit from a six-week therapy with pantoprozole. Twenty-nine out-patients with voice disorders (case history of at least two months) and simultaneous symptoms of gastropharyngeal reflux were recruited for this study. At the entry to the study a symptom questionnaire and a videolaryngo/stroboscopy were completed. The symptom questionnaire and the video-laryngo/stroboscopy were repeated after the six weeks of therapy with pantoprazole 40 mg once a day and again six weeks and three months after this follow-up, during which time the patient was without therapy.Hoarseness, globus pharyngeus, sore throat, heartburn, and coughing were the symptoms which showed a significant (p<0.05) recovery at the follow-ups (mean of hoarseness index: 7.28 to 0.92; mean of globus pharyngeus index: 3.14 to 0.58; mean of heartburn index: 2.86 to 0.5; mean of cough index: 1.72 to 0.25; mean of throat soreness index: 1.72 to 0.15). Laryngoscopy scores of the posterior laryngeal region, the glottic and the supraglottic region showed statistically significant improvement (p<0.05) after the treatment with pantoprazole. The therapeutic effect exceeded the drug administration until the last follow-up (after three months). The medication was tolerated without side-effects in all patients.A primary (ex juvantibus) therapy with proton pump inhibitors seems to be a therapeutic option for patients with long-lasting chronic inflammation of the larynx not responding to common therapy. In this case a six-week course of treatment has been shown to be sufficient.

scholarly journals SAT-121 Secretin Stimulation Test in a Patient Receiving Proton PUMP Inhibitor Therapy- to Do or Not to Do?

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Parvathy Madhavan ◽  
Hassaan Aftab ◽  
Beatriz Tendler
Keyword(s):  
Proton Pump Inhibitor ◽  
Proton Pump ◽  
Gastrin Level ◽  
Proton Pump Inhibitor Therapy ◽  
Stimulation Test ◽  
Duodenal Ulcers ◽  
Ulcer Disease ◽  
History Of ◽  
Secretin Stimulation ◽  
Chronic Nausea

Abstract Introduction: Complications of gastrinoma cause increase in mortality in patients with MEN syndrome. There are concerns that secretin stimulation test (SST) can produce false positive results in the setting of proton pump inhibitor (PPI) use. However, withholding the PPI treatment in a patient with severe peptic ulcer disease can be potentially unsafe. There is also a theoretical concern that abrupt withdrawal of PPI will cause a surge in gastrin. Here we discuss a case where SST yielded impressive results despite the use of PPI. Case report: 78 y.o. Caucasian male presented in December 2018 with chronic nausea, vomiting, diarrhea of 5-year duration. Further evaluation showed severe esophagitis with strictures, multiple gastric and duodenal ulcers and he was initiated on PPI. He also had h/o hyperparathyroidism diagnosed 2 years ago s/p parathyroidectomy (2 of 4 parathyroid glands removed) and one kidney stone in his late 20s and early 70s. He had no family history of any endocrine issues. Physical examination was unremarkable. Labs were significant for gastrin levels (nl &lt;100 pg/mL) of 375 pg/mL in 6/2016 and 219 pg/mL in 11/2018. SST was performed on 12/22/2018 which showed gastrin levels as follows: -10 min=405 pg/mL, - 5 min=404 pg/mL, + 2 min=3201 pg/mL, + 5 min=3439 pg/m, +10 min=2445 pg/mL, +20 min=1218 pg/mL, +30 min=578 pg/mL. He was diagnosed with gastrinoma based on the SST results. Genetic testing did not show any pathogenic sequence variants or deletions/duplications identified in MEN-1; CASR; CDC73; CDKN1B or RET. Given history of hyperparathyroidism and gastrinoma, he was clinically diagnosed with MEN1 syndrome. Ga-68 DOTATATE scan in May 2019 revealed focal radiotracer avidity in the tail the pancreas suspicious for neuroendocrine tumor and multiple radiotracer avid retroperitoneal and abdominal lymph nodes. Focal radiotracer avid lesion was also noted in the sacrum suspicious for osseous metastatic disease. He was started on lantreotide monthly injections in July 2019. Gastrin level decreased to 94 pg/mL 1 week after first injection, however later increased to 304 pg/ml 1 week after third dose of lantreotide. Surgical options are also being explored. Conclusion: An increase in more than 120pg/mL over basal gastrin level within 10 min in SST is consistent with a diagnosis of gastrinoma. Our patient demonstrated an impressive increase in gastrin level with SST while on PPI therapy. Pertinent diagnostic information was successfully obtained without increasing the risk of complications that can occur by withdrawal of PPI therapy.

scholarly journals Gastric Hyperplastic Polyps Associated with Proton Pump Inhibitor Use in a Case without a History of Helicobacter pylori Infection

2017 ◽  
Vol 56 (14) ◽  
pp. 1825-1829 ◽  
Author(s):  
Shuichi Miyamoto ◽  
Mototsugu Kato ◽  
Kana Matsuda ◽  
Satoshi Abiko ◽  
Momoko Tsuda ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Proton Pump Inhibitor ◽  
Proton Pump ◽  
Hyperplastic Polyps ◽  
History Of
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