Atlarda Mide Ülseri Sendromuna Genel Bakış

Year 2017, Volume: 14 Issue: 2, 125 - 135, 15.08.2017

Gülşah Kaya Karasu Ali Cesur Onmaz

Abstract

Bu derlemenin amacı atlarda sıklıkla karşılaşılan mide ülseri sendromunun oluşumunun temel prensipleri ile

teshiş, farmakolojik tedavi ve tedavide beslenmenin rolü hakkında bilgi vermektir. Atlarda mide ülseri sendromu; terminal

yemek borusunda, proksimal (skuamöz) mide, distal (glandüler) mide ve proksimal duodenumun ülseri ile karakterize

bir durumdur. Teşhisi; anamnez, klinik semptomlar ve kesin teşhis olarak da endoskopik muayene ile yapılır. Medikal

tedavisinde mide asit salgısını baskılayarak, mide pH’sının artmasını sağlayan çeşitli farmakolojik ajanlar kullanılır.

Son yıllarda beslenmenin mide ülserinin tedavisinde önemli bir rol oynadığı tespit edilmiş olup, diyet beslenme; medikal

tedaviye yardımcı ve hastalığın tekrar nüks etmesine karşı koruyucu olarak kullanılmaktadır.

Keywords

At, beslenme, mide ülseri, tedavi

Management of Equine Gastric Ulcer Syndrome

Abstract

The purpose of this review was to provide information about formation of equine gastric ulcer syndrome

(EGUS), the basic principles of diagnosis and treatment strategies (pharmacological treatment and the role of nutrition

in treatment). EGUS is characterized by ulceration in the terminal esophagus, proximal (squamous) stomach, distal

(glandular) stomach, and proximal duodenum. Diagnosis of EGUS requires a thorough history and physical examination.

However, gastroscopy is the only definitive diagnosis for gastric ulcers currently available. The mainstay of pharmacologic

treatment of EGUS is to increase stomach pH and suppress HCl acid secretion. In recent years, nutrition

has been found to play an important role in the treatment of stomach ulcers. The nutritional and dietary management

can be initiated during therapy to help facilitate ulcer healing and prevent ulcer recurrence.

Keywords

Equine, gastric ulcers, nutrition, treatment

References

• 1. Al Jassim RM, Andrews FM. The bacterial community of the horse gastrointestinal tract and its realtion to fermentative acidosis, laminitis, colic, and stomach ulcers. Vet Clinic Equine 2009; 25(2): 199-215. 2. Andrews F, Bernard W, Byars D, Cohen N, Divers T, MacAllister C, McGladdery A, Merritt A, Murray M, Orsini J, Snyder J, Vatistas N. Recommendations for the diagnosis and treatment of equine gastric ulcer syndrome (EGUS). Equine Vet Educ 1999; 11(5): 262- 72. 3. Andrews FM, Nadeau JA. Clinical syndromes of gastric ulceration in foals and mature horses. Equine Vet J Suppl 1999; 31(29): 30 -3. 4. Andrews FM, Sifferman RL, Bernard W, Hughes FE, Holste JE, Daurio CP, Alva R, Cox JL. Efficacy of omeprazole paste in the treatment and prevention of gastric ulcers in horses. Equine Vet J Suppl 1999; 31(29): 81 -6. 5. Andrews FM, Reinemeyer CR, McCracken MD, Blackford JT, Nadeau JA, Saabye L, Sötell M, Saxton A.Comparison of endoscopic, necropsy and histology scoring of equine gastric ulcers. Equine Vet J 2002; 34 (5): 475-8. 6. Andrews FM, Buchanan BR, Smith SH, Elliott SB, Saxton AM. In vitro effects of hydrochloric acid and various concentrations of acetic, propionic, butyric, or valeric acids on bioelectric properties of equine gastric squamous mucosa. Am J Vet Res 2006; 67(11): 1873-82. 7. Bell RJW, Kingston JK, Mogg TD, Perkins NR. The prevalence of gastric ulceration in racehorses in New Zealand. N Z Vet J 2007; 55(1): 13-8. 8. Bezdekova B, Jahn P, Vyskocil M. Gastric ulceration, appetite, and feeding practices in standardbred racehorses in the Czech Republic. Acta Vet Brno 2008; 77(4): 603-7. 9. Birkmann K, Junge HK, Maischberger E, Wehrli Eser M, Schwarzwald CC. Efficacy of omeprazole powder paste or enteric-coated formulation in healing of gastric ulcers in horses. J Vet Int Med 2014; 28(3): 925-33. 10. Buchanan BR, Andrews FM. Treatment and prevention of equine gastric ulcer syndrome. Vet Clin Equine 2003; 19(3): 575-97. 11. Cargile JL, Burrow JA, Kim I, Cohen ND,Merritt AM. Effect of dietary corn oil supplementation on equine gastric fluid acid, sodium, and prostaglandin E2 content before and during pentagastrin infusion. J Vet Intern Med 2004; 18(4): 545-9. 12. Carter S, Pellegrini FA. The use of novel antibody tools to detect the presence of blood in equine feces. Company Bulletin Freedom Health. LLC 2006; pp. 1-3. 13. Chameroy KA, Nadeau JA, Bushmich SL, Dinger JE, Hoagland TA, Saxton AM. Prevalence of non-glandular gastric ulcers in horses involved in a university riding program. J Equine Vet Sci 2006; 26(5): 207-11. 14. Contreras M, Morales A, Garcia-Amado MA, De Vera M, Bermúdez V, Gueneau P.Detection of Helicobacter-like DNA in the gastric mucosa of thoroughbred horses. Lett Appl Microbiol 2007; 45(5): 553-7. 15. Daurio CP, Holste JE, Andrews FM, Merritt AM, Blackford JT, Dolz F, Thomspson DR. Effect of omeprazole paste on gastric acid secretion in horses. Equine Vet J 1999; 31 (29): 59-62. 16. Elliott SN, Buret A, McKnight W, Miller MJ, Wallace JL. Bacteria rapid colonize and modulate healing of gastric ulcer in rats. Am J Physiol Gastrointest Liver Physiol 1998; 275(3-1) :425-32 17. Fennell, LC, Franklin RP, Do nonsteroidal anti-inflammatory drugs administered at therapeutic dosages induce gastric ulcers in horses? Equine Vet Educ 2009; 21(12): 660 -2. 18. Frank N, Andrews FM, Elliott SB, Lew J. Effects of dietary oils on the development of gastric ulcers in mares. Am J Vet Res 2005; 66(11): 2006-11. 19. Fox JG. The non-H. pylori helicobacters: Their expanding role in gastrointestinal and systemic disease. Gut 2002; 50(2): 273-83. 20. Furr M, Taylor L, Kronfeld D. The effects of exercise training on serum gastrin responses in the horse. Cornell Vet 1994; 84(1): 41 -5. 21. Hammond CJ, Mason DK, Watkins KL. Gastric ulceration in mature Thoroughbred horses. Equine Vet J 1986; 18(4): 284-87. 22. Hepburn RJ. Endoscopic examination of the squamous and glandular gastric mucosa in sport and leisure horses: 684 horses (2005– 2011). Proc 11th International Equine Colic Research Symposium. 7th -10th July, 2014, Dublin, Ireland. p. 5. 23. Hepburn RJ, Proudman CJ. Treatment of ulceration of the gastric glandular mucosa: Retrospective evaluation of omeprazole and sucralfate combination therapy in 204 sport and leisure horses. Proc 11th International Equine Colic Research Symposium. 7th -10th July, 2014, Dublin, Ireland. p.108. 24. Holbrook TC, Simmons RD, Payton ME, Macalister CG. Effect of repeated oral administration of hypertonic electrolyte solution on equine gastric mucosa. Equine Vet J 2005; 37(6): 501-4. 25. Husted L, Sanchez LC, Olsen SN, Baptiste KE, Merritt AM. Effect of paddock vs. stall housing on 24 hour gastric pH with the proximal and ventral equine stomach. Equine Vet J 2008; 40(4): 337-41. 26. Geetha S, Ram MS, Singh V, Ilavazhagan G, Sawhney RC. Anti-oxidant and immunomodulatory properties of seabuckthorn (Hippophae rhamnoides) an in vitro study. J Ethnopharmacol 2002; 79(3): 373-78. 27. Javsicas LH, Sanchez LC. The effect of omeprazole paste on intra-gastric pH in clinically ill neonatal foals. Equine Vet J 2008; 40(1): 41-4. 28. Jenkins CC, Blackford JT, Andrews F, Frazier DL, Mattsson H, Olovsson SG, Peterson A. Duration of antisecretory effects of oral omeprazole in horses with chronic gastric cannulae. Equine Vet J 1992; 24(13): 89-92. 29. Jones SL. Gastric ulcer disease. Proceedings of the North American Veterinary Conference, 7-11 January, 2006, Orlando, Florida, USA, pp.130-1. 30. Jonsson H, Egenvall A. Prevalence of gastric ulceration in Swedish Standard breds in race training. Equine Vet J 2006; 38(3): 209- 13. 31. Kaya-Karasu G, Huntington PJ, Iben C, Onmaz AC. Poor performance associated with equine gastric ulcer in an Arabian race horse. Erciyes Üniv Vet Fak Derg 2016 (Baskıda, Kabul Tarihi:05.01.2016). 32. Le Jeune SS, Nieto JE, Dechant, JE, Snyder JR. Prevalence of gastric ulcers in Thoroughbred broodmares in pasture: a preliminary study. Vet J 2009; 181(3): 251- 5. 33. Lester GD, Robinson I, Secombe C. Risk Factors for Gastric Ulceration in Thoroughbred Racehorses. Canberra: Australian Government: Rural Industries Research and Development Corporation; 2008; pp.1- 42. 34. Lorenzo-Figueras M, Merritt AM. Effects of exercise on gastric volume and pH in the proximal portion of the stomach of horses. Am J Vet Res 2002; 63(11): 1481-7. 35. Luthersson N, Hou Nielsen K, Harris P, Parkin TDH. Equine gastric ulceration syndrome (EGUS) in 201 horses in Denmark and the influence of age, sex, temperament, breed and workload. Equine Vet J 2009a; 41: 619-24. 36. Luthersson N, Hou Nielsen K, Harris P, Parkin TDH. Risk factors associ-ated with equine gastric ulceration syndrome (EGUS) in 201 horses in Denmark. Equine Vet J 2009b; 41 (7): 625-30. 37. Lybbert T, Gibbs P, Cohen N. Feeding alfalfa hay to exercising horses reduces the severity of gastric squamous ulceration. Proceedings of the 53rd Annual Convention of the American Association of Equine Practitioners, 1-5 December, 2007, Orlando, Florida, USA, p. 525-6. 38. MacAllister CG, Sangiah S, Mauromoustakos A. Effect of a hista-mine H2 type receptor antagonist (WY 45, 727) on the healing of gastric ulcers in ponies. J Vet Intern Med 1992; 6(5): 271-5. 39. MacAllister CG. A review of medical treatment for peptic ulcer disease. Equine Vet J Suppl. 1999; 31(29): 45-9. 40. MacAllister CG, Morgan SJ, Borne AT, Pollet RA. Comparison of adverse effects of phenylbutazone, flunixin meglumine, and ketoprofen in horses. J Am Vet Med Assoc 1993; 202(1): 71-7. 41. MacAllister CG, Andrews FM, Deegan E, Ruoff W, Olovson SG. A scoring system for gastric ulcers in the horse. Equine Vet J 1997; 29(6): 430-33. 42. Metayer N, Lhote M, Bahr A, Cohen ND, Kim I, Roussel AJ, Julliand V. Meal size and starch content affect gastric emptying in horses. Equine Vet J 2004; 36(5): 436-40. 43. McClure SR, Glickman LT, Glickman NW. Prevalence of gastric ulcers in show horses. J Am Vet Med 1999; 215(8): 1130-33. 44. Merrit AM, Sanchez LC, Burrow JA, Church M, Hill S. Bioavailability of Gas-trogard vs. three generic compounded omeprazole preparations in mature horses. Proc 7th International Colic Research Symposium, Manchester, UK, 2002, p. 81. 45. Merritt AM, Sanchez LC, Burrow JA, Church M, Ludzia S. Effect of GastroGard and three compounded oral omeprazole preparations on 24 h intragastric pH in gastrically cannulated mature horses. Equine Vet J 2003; 35 (7): 691-5. 46. Meyer H, Coenen M, Gurer C. Investigations of saliva production and chewing in horses fed various feed. Proc Equine Nutr Physiol Symp Lansing, Michigan, USA. Equine Nutrition and Physiology Society, Savoy, IL, 1985, p. 38-41. 47. Moyaert H, Decostere A, Vandamme P, Debruyne L, Mast J, Baele M, Ceelen L, Ducatelle R, Haesebrouck F. Helicobacter equorum sp. nov., a urease-negative Helicobacter species isolated from horses faeces. Int J Syst Evol Microbiol 2007; 57(2): 213-8. 48. Murray MJ, Schusser GF. Application of gastric pH-metry in horses: measurement of 24 hour gastric pH in horses fed, fasted and treated with ranitidine. J Vet Intern Med 1989; 7(6): 133. 49. Murray MJ. Diagnosing and treating gastric ulcers in foals and horses. Vet Med 1991; 8: 820-7. 50. Murray MJ. Aetiopathogenesis and treatment of peptic ulcer in the horse: a comparative review. Equine Vet J Suppl 1992; 24 (13): 63-74. 51. Murray MJ, Grodinsky C. The effect of famotidine, ranitidine and magnesium hydroxide/ aluminium hydroxide on gastric fluid pH in adult horses. Equine Vet J 1992; 24 (11): 52-5 52. Murray MJ. Equine model of inducing ulceration in alimentary squamous epithelial mucosa. Dig Dis Sci 1994; 39(12): 2530-35. 53. Murray MJ, Schusser GRF, Pipers FS, Gross SJ. Factors associated with gastric lesions in thoroughbred racehorses. Equine Vet J 1996; 28(5): 368-374. 54. Murray MJ, Eichorn ES. Effects of intermittent feed deprivation, intermittent feed deprivation with ranitidine administration, and stall confinement with ad libitum access to hay on gastric ulceration in horses. Am J Vet Res 1996; 57(11): 1599-603. 55. Murray MJ, Haven ML, Eichorn ES, Zhang D, Eagleson J, Hickey GJ. Effects of omeprazole on healing of naturallyoccurring gastric ulcers in Thoroughbredrace-horses. Equine Vet J, 1997; 29(6): 425 -29. 56. Murray MJ, Nout YS, Ward DL. Endoscopic findings of the gastric antrim and pylorus in horses: 162 cases (1996–2000). J Vet Intern Med 2001; 15(4): 401-6. 57. Murray MJ. Diseases of the stomach. In: Smith BP, ed. Large Animal Internal Medicine. 3 rd. Missouri: Mosby Elsevier; 2009; p.695-702. 58. Nadeau JA, Andrews FM, Mathew AG, Argenzio RA, Blackford JT, Sohtell M, Saxton AM. .Evaluation of diet as a cause of gastric ulcers in horses. Am J Vet Res 2000; 61(7): 784-90. 59. Nadeau JA, Andrews FM, Patton CS, Argenzio RA, Mathew AG, Saxton AM.Effects of hydro-choloric, acetic, butyric, and propionic acids on pathogenesis of ulcers in the nonglandular portion of the stomach of horses. Am J Vet Res 2003a; 64(4): 404-12. 60. Nadeau JA, Andrews, FM, Patton CS, Argenzio RA, Mathew AG, Saxton AM.Effects of hydro-choloric, valeric, and other volatile fatty acids on pathogenesis of ulcers in the nonglandular portion of the stomach of horses. Am J Vet Res 2003b; 64: 413-7. 61. Nieto JE, Snyder JR, Beldomenico P, Aleman M, Kerr JW, Spier SJ. Prevalence of gastric ulcers in endurance horses – a preliminary report. Vet J 2004; 167(1): 33-7. 62. O’connor MS, Steiner JM, Roussel AJ, Williams DA, Meddings JB, Pipers F, Cohen ND. Evaluation of sucrose concentration for detection of gastric ulcers in horses. Am J Vet Res 2004; 65(1): 31-9. 63. Pellegrini FL. Results of a large scale necroscopic study of equine colonic ulcers. J Equine Vet Sci 2005; 25(3): 113-17. 64. Rabuffo TS, Orsini JA, Sullivan E, Engiles J, Norman T, Boston R. Associations between age, sex and prevalence of gastric ulceration in standardbred racehorses in training. J Am Vet Med Assoc 2002; 221(8): 1156-9. 65. Reed SK, Messer NT, Tessman RK, Keegan KG. Effects of phenylbutazone alone or in combination with flunixin meglumine on blood protein con-centrations in horses. Am J Vet Res 2006; 67(3): 398-402. 66. Reese RE, Andrews FM, Elliott SB. The effect of seabuckthorn berry extract (Seabuck Complete) on prevention and treatment of gastric ulcers in horses. Proceedings of the 9th International Equine Colic Research Symposium. 15–18June, Liverpool, England, 2008. 67. Sandin A, Skidell J, Häggström J, Girma K, Nilsson G.Post-mortemfindings of gastric ulcers in Swedish horses up to 1 year of age: A retrospective study 1924–1996. Acta Vet Scand 1999; 40(2): 109–20. 68. Sandin A, Skidell J, Häggström J, Nilsson G. Post mortem findings of gastric ulcers in Swedish race horses older than age one year: a retrospective study of 3715 horses, (1924–1996). Equine Vet J 2000; 32(1): 36– 42. 69. Sykes BW, Sykes KM, Hallowell GD. A comparison of three doses of omeprazole in the treatment of gastric ulceration in the horse: A randomised, blinded clinical trial. Equine Vet J 2015; 47(3): 285-90 70. Sykes BW, Underwood C, McGowan C, Mills P. Pharmacokinetics and bioavailability of five commercially available formulations of omeprazole. J Vet Pharm Ther 2015; 46 (47): 1–6. 71. Sykes BW, Sykes KM, Hallowell GD. A comparison of two doses of omeprazole in the treatment of EGUS: A blinded, randomised, clinical trial. Equine Vet J 2014; 46(4): 416-21. 72. Thorne JB, Goodwin D, Kennedy MJ, Davidson HPB, Harris P. Foraging enrichment for individually housed horses: practicality and effects on behaviour. Appl Anim Behav Sci 2005; 94(1-2): 149-64. 73. Tomlinson J, Blikslager A. Role of nonsteroidal anti-inflammatory drugs in gastrointestinal tract injury and repair. J Am Vet Med Assoc 2003; 222(7): 946-51. 74. Vastista NJ, Snyder JR, Carlson G, Johnson B, Arthur RM, Thurmond M, Zhou H, Llyod KL. Epidemiological study of gastric ulceration in the thoroughbred race horse: 202 horses 1992-1993. Proc Am Assoc Equine Pract 1994; 40: 125–6. 75. Vatistas NJ, Sifferman RL, Holste J, Cox JL, Pinalto G, Schultz KT. Induction and mainte -nance of gastric ulceration in horses in simulated race training. Equine Vet J Suppl 1999b; 31(29): 40-4. 76. Venner M, Lauffs, S, Deegen E. Treatment of gastric lesions in horses with pectinlecithin complex. Equine Vet J Suppl. 1999; 29: 91-6. 77. Videla R, Andrews FM. New perspectives in equine gastric ulcer syndrome. Vet Clin Nother Am Equine Pract 2009; 25(2): 283–301.