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Related Concept Videos

Peptic Ulcer Disease I: Introduction01:30

Peptic Ulcer Disease I: Introduction

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Peptic Ulcer Disease (PUD) is characterized by mucosal excavation in the esophagus, stomach, pylorus, or duodenum. It can manifest as acute or chronic based on the extent and duration of mucosal involvement.
An acute ulcer, marked by superficial erosion and minimal inflammation, swiftly resolves upon identifying and addressing the underlying cause. In contrast, a chronic ulcer persists, potentially eroding through the muscular wall and forming fibrous tissue.
Peptic ulcers can also be...
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Drugs for Treatment of Constipation-Predominant IBS01:21

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Pharmacological therapies for IBS-C are designed to alleviate abdominal discomfort and enhance bowel function. In patients with IBS-C, fiber supplements may help soften stools and decrease straining, but may also lead to increased gas production and bloating. Osmotic laxatives like milk of magnesia are frequently used to soften stools and increase stool frequency in IBS-C patients. In addition, two drugs approved for use in severe IBS-C adult cases are linaclotide (Linzess) and lubiprostone...
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Peptic Ulcer Disease II: Pathophysiology01:28

Peptic Ulcer Disease II: Pathophysiology

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Peptic Ulcer Disease (PUD) is characterized by the development of ulcers in the stomach or duodenal mucosa. Its pathophysiology is complex, involving a balance between damaging and protective elements.
Damaging agents such as Helicobacter pylori, gastric acid, pepsin, and nonsteroidal anti-inflammatory drugs (NSAIDs) can weaken the mucosal defense, allowing hydrogen ions to infiltrate back and harm epithelial cells.
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Pathophysiology of Peptic Ulcer Disease: Mucosal Defense Factors01:24

Pathophysiology of Peptic Ulcer Disease: Mucosal Defense Factors

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Peptic ulcer disease, commonly called PUD, represents a multifaceted condition characterized by disruptions in the lining of the gastrointestinal (GI)  tract. Central to the protection of the gastrointestinal lining is the mucosal-bicarbonate barrier. This physiological defense mechanism is a formidable shield against the corrosive effects of gastric acid and pepsin secretion in the stomach. Its role is pivotal in maintaining the structural integrity of the stomach's inner lining.
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Peptic Ulcer Disease III: Clinical Manifestations and Diagnostic Studies01:28

Peptic Ulcer Disease III: Clinical Manifestations and Diagnostic Studies

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Peptic ulcer disease (PUD) presents with diverse symptoms depending on the location and severity of the ulcer. Clinical manifestations of peptic ulcer include dull pain and a burning sensation in the mid-epigastric region.
Few clinical manifestations differentiate gastric ulcers from duodenal ulcers. Distinctions in the location, timing, and pain relief are crucial for healthcare providers in differentiating between gastric and duodenal ulcers during clinical assessments.
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Bacterial Flora of the Large Intestine01:29

Bacterial Flora of the Large Intestine

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The gut microbiome is formed by a vast and diverse community of bacteria that colonizes our large intestine. These bacteria start residing in the gut from birth and continue diversifying throughout life, influenced by factors such as diet, lifestyle, and stress. The gut bacterial community also includes bacteria from food and those that enter the colon through the anus.
The normal gut flora of the colon plays a critical role in generating essential vitamins such as vitamins K, B5, and B7.
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Adjunctive Diode Laser Therapy and Probiotic Lactobacillus Therapy in the Treatment of Periodontitis and Peri-Implant Disease
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Widespread pustular eruption following probiotic use.

Kyla N Price, Aleksi J Hendricks, Mackenzie E Goodrich

  • 1Division of Dermatology, University of Arkansas for Medical Sciences, Little Rock, AR. vivian.shi918@gmail.com.

Dermatology Online Journal
|December 20, 2020
PubMed
Summary
This summary is machine-generated.

A rare case of acute generalized exanthematous pustulosis (AGEP) occurred after probiotic use in a Crohn disease patient. Ustekinumab treatment may have reduced the typical pustular rash presentation.

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Area of Science:

  • Dermatology
  • Gastroenterology
  • Immunology

Background:

  • Crohn disease and palmoplantar psoriasis are immune-mediated conditions.
  • Ustekinumab is an interleukin-23 (IL-23) inhibitor used in treating these conditions.
  • Probiotics are commonly used supplements, but their adverse effects are not fully understood.

Observation:

  • A 26-year-old woman on ustekinumab developed a pruritic rash with few pustules shortly after starting an over-the-counter probiotic.
  • Skin biopsy showed psoriasiform and spongiotic dermatitis with subcorneal pustules and eosinophils.
  • This presentation was consistent with acute generalized exanthematous pustulosis (AGEP).

Findings:

  • The patient exhibited a unique, less pustular form of AGEP.
  • Probiotic initiation was temporally associated with the rash onset.
  • Interleukin-23 (IL-23) suppression by ustekinumab may have influenced the clinical presentation.

Implications:

  • This case suggests a potential, albeit rare, association between probiotic use and AGEP in patients on IL-23 inhibitors.
  • The findings highlight the importance of considering medication interactions and immune status in drug-induced skin reactions.
  • Further research is warranted to explore the immunomodulatory effects of probiotics in patients with inflammatory diseases.