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Long-term use of PPIs is associated with the development of benign polyps from fundic glands (which is distinct from fundic gland polyposis); these polyps do not cause cancer and resolve when PPIs are discontinued. [33] There is concern that use of PPIs may mask gastric cancers or other serious gastric problems. [33]
Proton pump inhibitors are more potent at reducing gastric acid production since that is the final common pathway of all stimulation of acid production. In pernicious anemia , autoantibodies directed against parietal cells or intrinsic factor cause a reduction in vitamin B 12 absorption.
The H 2 receptor antagonists are a class of drugs used to block the action of histamine on parietal cells in the stomach, decreasing the production of acid by these cells. H 2 antagonists are used in the treatment of dyspepsia, although they have been surpassed in popularity by the more effective [1] proton pump inhibitors.
The gastric hydrogen potassium ATPase or H + /K + ATPase is the proton pump of the stomach.It exchanges potassium from the intestinal lumen with cytoplasmic hydronium [2] and is the enzyme primarily responsible for the acidification of the stomach contents and the activation of the digestive enzyme pepsin [3] (see gastric acid).
Proton pump inhibitors (PPIs) block the gastric hydrogen potassium ATPase (H + /K + ATPase) and inhibit gastric acid secretion. These drugs have emerged as the treatment of choice for acid-related diseases, including gastroesophageal reflux disease (GERD) and peptic ulcer disease. PPIs also can bind to other types of proton pumps such as those ...
Cimetidine was the prototypical histamine H 2 receptor antagonist from which later drugs were developed. Cimetidine was the culmination of a project at Smith, Kline & French (SK&F; now GlaxoSmithKline) by James W. Black, C. Robin Ganellin, and others to develop a histamine receptor antagonist that would suppress stomach acid secretion.
[55] [32] H. pylori-induced gastric cancer is the third highest cause of worldwide cancer mortality as of 2018. [56] Because of the usual lack of symptoms, when gastric cancer is finally diagnosed it is often fairly advanced. More than half of gastric cancer patients have lymph node metastasis when they are initially diagnosed. [57]
Gastric aspiration and or lavage, where a tube is inserted into the stomach via the nose in an attempt to determine if there is blood in the stomach, if negative does not rule out an upper GI bleed [20] but if positive is useful for ruling one in. [14] Clots in the stool indicate a lower GI source while melana stools an upper one. [14]