Gastrointestinal stress ulcer prophylaxis in the intensive care unit, where is the data?

Protective Effects of Some Graded Iranian Honey Samples Against Cold Water Immersion-Induced Gastric Ulcers in Rats

Honey has a rich history of treating gastrointestinal diseases due to its diverse bioactive compounds. This study evaluated the protective effects of select Iranian honeys against cold water immersion stress (CWIS)-induced ulcers in rats. Forty male Wistar rats (250-280 g) were randomly assigned to eight groups (n = 5): control, CWIS, and groups treated with strong (eucalyptus, Annaab, and Jangale) and weak honeys (Chand Giah, Sumaq, Gaz) + CWIS. Honey selection was based on antioxidant capacity, phenolic content, and protein concentration. Rats received 20% honey in water (1 mL/kg) orally twice daily for 14 days; controls received water. After a 24-h fast, rats underwent 3-h CWIS to induce ulcers. Serum samples were analyzed for malondialdehyde (MDA), total antioxidant capacity (TAC), thiol groups, tumor necrosis factor alpha (TNF-α), and interleukin 6 (IL-6) levels. Stomachs were assessed for ulcer severity (gastric ulcer index), gastric juice volume, and histopathological changes. Honey types were categorized as strong (eucalyptus, Annaab, and Jangale) or weak (Chand Giah, Sumaq, and Gaz) based on total phenolic content, antioxidant effects (FRAP and DPPH), and protein levels. Ulcer group showed significant increases in MDA (64%) and TNF-α and IL-6 levels (98.5% and 111.6%), and decreases in ferric reducing antioxidant power and 2,2-diphenyl-1 picrylhydrazyl (FRAP, DPPH, and thiol levels [26%, 14.39%, and 26%]) compared to controls. Strong honey groups exhibited 50% lower gastric ulcer index compared to weak honey groups. This study showed that strong honeys, due to their higher phenolic, total protein, and antioxidant content, offer greater protection against gastric damage and oxidative stress compared to weaker honeys. These results highlight the importance of bioactive compounds in honey's therapeutic properties. Therefore, high-quality honeys with higher phenolic content can be considered as therapeutic supplements for gastrointestinal disorders, especially those caused by oxidative stress and inflammation.

Emerging Trends and their Impacts on Peptic Ulcer Diseases: Treatments and Techniques

Background:

Peptic ulcer disease (PUD) is prevalent in almost all parts of the world. PUD complications are creating a major source of preventable health care expenses. The major factors responsible for the incidence of PUD and its complication have changed over the past few decades after the identification of non-steroidal inflammatory drugs (NSAIDs) and Helicobacter pylori bacterial infection along with a marked increase in the use of proton-pump inhibitors (PPIs) as drug therapy. The management of PUD has become more complex and challenging due to antimicrobial resistance.

Objective:

The objective of the study was to highlight current therapy and novel techniques used in the treatment of peptic ulcer diseases.

Methods:

An exhaustive literature search has been conducted across PubMed, Google, Scopus and Web of Science as an electronic database to add the crucial information from the relevant literature.

Results:

In the present review, we have discussed PUD and its pathophysiology. The recent trends in PUD and possible treatments with novel techniques have also been discussed. The type and presence of ulcers cannot be predicted accurately based on symptoms. The available treatment approaches for peptic ulcers based on their clinical presentation and etiology are anti-secretary therapy, endoscopy to reveal ulcers followed by drug therapy, and triple therapy for H pylori infection.

Conclusion:

Thus, the popular and effective methods are very beneficial in controlling PUD. The treatment based on diagnosis is the foremost requirement for ameliorating any disorder. In this article, the emerging techniques and development in the treatment and diagnosis of PUD have been reviewed.