This paper deals with the clinical history, the histopathological and scanning electron microscopy (SEM) pictures, treatment and follow up of four cases of intestinal spirochaetosis. Diarrhoea was a prominent symptom in all cases but distension and vague abdominal trouble were also present. It is suggested that heavy infestation of the gut surface epithelium by spirochaetes acts as a barrier for the normal absorptive processes and leads to diarrhoea.
Gad A, Hradsky M, Furugird K, Malmodin B, Nyberg 0. Campylobacter pylori and non-ulcer dyspepsia. 2. A prospective study in a Swedish population. Scand J Gastroenterol 1989,24 (Suppl 167), 44-48 In a consecutive prospective series of 186 Swedish persons with the diagnosis of nonulcer dyspepsia 71.5% were found to have gastritis and/or bulbar duodenitis in endoscopic biopsies. Gastroduodenitis was associated with campylobacter pylon (CP) in 83.5% of the cases. The double therapeutic approach using an antibiotic and a preparation containing bismuth in an uncontrolled therapeutic pilot trial resulted in improvement of the histological picture, disappearance of CP and amelioration of symptoms. It is concluded that CP-infection plays a central role in the pathogenesis of gastroduodenitis associated NUD.In a paper published elsewhere in this supplement a series of Italian non-ulcer dyspepsia (NUD) patients were found to have campylobacter pylori (CP) associated gastritis in more than 74% of the antral biopsies (1). It was concluded that NUD seems to be a disease with an underlaying multifactorial aetiology and further studies were urged to investigate the possibility of a causal relationship between mucosal colonisation with CP and gastroduodenitis.The present study was designed to answer this question, to determine the prevalence of CP in NUD and to relate this to histological abnormalities. This is, to the best of our knowledge, the first prospective study in a Swedish NUD population which allows follow-up of the symptoms, the degree of mucosal inflammation and CP colonisation after treatment with an antibiotic and a preparation containing bismuth.
MATERIALS AND METHODSThis study was carried out from the first of January through December 1987. It is based on 186 consecutive outpatient non-ulcer dyspepsia (NUD) patients, 108 females and 78 males, ranging in age from 18 to 86 years with a median of 54.3 years. The number of patients in the various age groups is shown in Fig. 1. NUD was defined as in another publication elsewhere in this supplement (1). The patients were referred for upper ga-8 1 B *!e 2 1 I 20-19 29 16 40-50-60-2 19 49 59 69 70 Age range Fig. 1. The distribution of 186 NUD patients according to age. Scand J Gastroenterol Downloaded from informahealthcare.com by University of Otago on 12/27/14 For personal use only.
Gad A, Hradsky M, Furuglrd K, Malmodin B. Campylobacter Pylori and gastroduodenal ulcer disease. Scand J Gastroenterol 1989,24 (Suppl 167), 81-85In a consecutive prospective series of 208 Swedish primary peptic ulcer patients, 146 gastric, 55 duodenal and 7 in both sites, gastroduodenitis was found in 97.6% of the cases. The mucosal inflammation was associated with CP in 87% and 91% of the gastric and duodenal ulcer cases respectively. No significant correlation was found between CP colonisation and the type or severity of mucosal inflammation. Gastric metaplasia was present in only 8% of 48 bulbar ulcer cases. Ulcer healing and eradication of CP was achieved in 52% of patients treated with bismuth subnitrate in combination with erythromycin or according to the triple approach.
The effect of metoclopramide and placebo on relaxation of a spasmodic pylorus during gastroscopy have been compared using a double blind technique. Metoclopramide showed a better result and the difference between its effect and the effect of placebo is statistically significant (p <0.01). Metoclopramide is a useful agent during gastroscopic examination in cases of spasmodic pylorus. It facilitates the passage of the gestroscope through the spasmodic pyloric sphincter. The reported relaxation and dilatation of the pyloric sphincter clarifies the amelioration of symptoms in different gastrointestinal troubles.
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