Buy Cytotec Online UK
The active ingredient of Cytotec tablets is a synthesized analogue of prostaglandin E1 produced by the body. This molecule enhances the protective properties of the gastrointestinal mucosa by stimulating the production of mucus by glandular cells of the stomach. Cytotec should be used for ulcerative lesions of the duodenum with or without bleeding, ulcerative lesions of the stomach with or without bleeding.
Cytotec stimulates the flow of blood to the mucous membranes, the process of producing bicarbonate and protective mucus, promotes the healing of ulcers and erosions in the gastrointestinal tract.
There are reviews of Cytotec as a preventive agent that can prevent the appearance of erosive lesions on the mucous membrane of the gastrointestinal tract.
It was also established that the drug inhibits stimulated and nocturnal production of hydrochloric acid in the stomach, increases the strength and frequency of contraction of intestinal muscles. The effect of the drug begins half an hour after administration, lasts another 3-6 hours.
The release form - Cytotec Release in tablets.
Indications for use. Cytotec according to the instructions prescribed for the prevention and treatment of erosions and peptic ulcer disease. Because misoprostol causes a reduction in myometrium, Cytotec is used to terminate a pregnancy. Apply for this indication the drug in combination with the antigestagen mifepristone, under the supervision of a gynecologist.
Dosing and Administration
Cytotec for ulcers and erosions of the gastrointestinal tract take 600-800 mg per day in three or four doses. In some cases, it is allowed to use 800 mcg in two doses, and the latter should be taken at bedtime. Treatment for these indications lasts for 1-2 months, after which control endoscopy is performed to confirm the start of remission.
Patients suffering from renal insufficiency or hypersensitivity to misoprostol are advised to take only 100 micrograms of Cytotec.
Often the cause of the development of ulcerative lesions of the gastrointestinal tract becomes nonsteroidal anti-inflammatory drugs. In this case, during treatment with nonsteroids, Cytotec is recommended to take for prevention: 400-800 mcg in 2-4 doses. Prevention lasts as much as nonsteroid treatment.
For termination of pregnancy Cytotec is used in the third stage of medical abortion. At the third stage of medical abortion, a woman should visit the gynecologist again after 36-48 hours and take 400 mg of Cytotek under his control. In most cases, the fertilized egg comes out soon after taking the pills, less often - in a few days. One or two weeks after an abortion, there is scant bloody discharge from the vagina.
Judging by the reviews of Cytotec, menstruation after using the drug to terminate pregnancy occurs in 28-32 days.
Cytotec can cause flatulence, vomiting, abdominal pain, nausea, diarrhea or constipation, painful or prolonged and heavy menstruation, bleeding from the uterus, not associated with the menstrual cycle. There are reviews of Cytotec, causing asthenia, convulsions, skin rashes, weight changes, and increased fatigue.
In case of overdose, drowsiness, tremor, shortness of breath, lethargy, diarrhea, reduction of pressure, fever, bradycardia, palpitations may occur. Treatment in this case is carried out symptomatic, hemodialysis is considered ineffective.
When using Cytotec for interrupting pregnancy, a woman may feel nagging pain in the lower abdomen and cramping pains when the egg leaves. There are cases when, under the action of drugs in women, the uterus ruptured, uterine bleeding opened.
Cytotec on instructions is contraindicated in children under 18 years of age, patients with severe hypersensitivity to misoprostol, pregnant, lactating women.
Under supervision, it is recommended to take the drug for ischemic heart disease, low blood pressure, cerebral arteriosclerosis, diarrhea, enterocolitis, epilepsy, impaired blood circulation of the brain, coronary cardiosclerosis.
It is strictly forbidden to use Cytotec to terminate a pregnancy on your own at home due to the risk of bleeding and death.
Stages of development of the ulcerative process of the stomach
Peptic ulcer is a heterogeneous disease with a multifactorial etiology and complex pathogenesis. The basis of the pathological process is inflammation of the mucous membrane of the gastroduodenal zone with the formation of a local injury, the morphological equivalent of which is a defect of the mucous and submucosal layer with an outcome in the connective tissue scar.
Peptic ulcer is a chronic recurrent disease, occurring with alternating periods of exacerbation and remission. In the modern clinic, duodenal ulcer localization, occurring 8-10 times more often, dominates localization in the stomach area. Typical for peptic ulcer are seasonal periods of increased pain and dyspeptic disorders. You should also consider the possibility of asymptomatic peptic ulcer disease. The frequency of such cases according to the literature can reach 30%.
It is believed that the imbalance between the factors of “aggression” and the factors of “protection” of the gastric mucosa and duodenum plays a crucial role in the pathogenesis of peptic ulcer.
Factors of aggression include: increased exposure to the acido-peptic factor associated with an increase in the production of hydrochloric acid and pepsin; violation of the motor-evacuation function of the stomach and duodenum (delay or acceleration of the evacuation of the acidic contents from the stomach, duodenogastric reflux).
Protection factors are: mucosal resistance to aggressive factors; production of gastric mucus; adequate bicarbonate production; active regeneration of the surface epithelium of the mucous membrane; sufficient blood supply to the mucous membrane; the normal content of prostaglandins in the wall of the mucous membrane; immune protection.
Great importance in the pathogenesis of peptic ulcer, especially duodenal ulcer, is attached to the infectious agent - Helicobacter Pylori (HP). On the one hand, the microorganism in the course of its vital activity, forming ammonia from urea, alkalizes the antrum of the stomach, which leads to hypersecretion of gastrin, constant stimulation of covering cells and hyperproduction of HCl, on the other hand, a number of its strains secrete cytotoxins that damage the mucosa. All this leads to the development of antral gastritis, gastric metaplasia of the duodenal epithelium, the migration of HP to the duodenum, the development of duodenitis and, ultimately, can be realized in a peptic ulcer.
Along with HP infection, an important role in the pathogenesis of ulcer is given to hereditary susceptibility to the disease and the use of nonsteroidal anti-inflammatory drugs (NSAIDs).
In foreign literature, the term “chronic peptic ulcer or duodenal ulcer” is adopted. This name reflects the main pathogenetic signs of the disease - the appearance of an ulcerative defect in the stomach or duodenum, as a result of the peptic effect on these organs of digestive enzymes. The term “peptic ulcer” dominates in Russia, and the presence of a detailed classification of the disease is necessary in connection with the traditions of the Russian therapeutic school and the requirements of the examination of working capacity.
The most common classification of peptic ulcer disease is the Johnson classification.
Classification A.G. Johnson (1990)
- Chronic ulcers of type I - ulcers of small curvature
- Chronic ulcers of type II - combined with duodenal ulcer, including healed duodenal ulcer
- Type III chronic ulcers - prepiloric ulcers
- Type IV chronic ulcers - acute superficial ulcers
- Chronic type II ulcers - due to Zollinger-Elisson syndrome
Classification of chronic gastric ulcers
Type I - single or multiple ulcers, ranging from the proximal (antral) part of the pyloric stomach to the cardia;
Type II - single or multiple ulcers of any part of the stomach in combination with an ulcer or erosions of the duodenum or healed duodenal ulcer;
Type III - ulcers of the pyloric ring or the supraureous zone (not further than 3 cm from the pyloric sphincter);
Type IV - multiple ulcers, subject to a combination of ulcer pylorus and supra-gate area with ulceration of any overlying stomach section;
V type - secondary ulcers of any part of the stomach, developed as a result of various local causes of non-ulcer etiology.
Classification of gastroduodenal ulcers according to ICD-10
1. A gastric ulcer (gastric ulcer) (Cipher C 25), including peptic ulcers of the pyloric and other parts of the stomach.
2. Duodenal ulcer (peptic ulcer disease), including peptic ulcer of all parts of the duodenum.
3. Gastrojejunal ulcer, including peptic ulcer (Cipher C 28) of the gastric anastomosis, which leads and removes the small intestine loops, fistula with the exception of the primary ulcer of the small intestine.
From the point of view of surgical practice, the complicated course of peptic ulcer has acute clinical significance - acute gastroduodenal bleeding; penetration of ulcers in neighboring organs; ulcer perforation; pyloroduodenal cicatricial stenosis (compensated, subcompensated, decompensated); periviscerita (perigastritis, periduodenitis); reincarnation of ulcers in cancer.
Endoscopic semiotics of peptic ulcer
In most cases, gastric ulcers are located along its lesser curvature in the prepyloric and pyloric departments. Less commonly, they are located in the cardiac and subcardial regions. More than 90% of gastric ulcers are located on the border between the zones of the gastric and pyloric glands, usually on the side of the pyloric glands. This corresponds to the section of the wall of the stomach, limited by the anterior and posterior oblique fibers and a circular layer of the muscular layer of the stomach wall, where during its movements there is the greatest stretching of the wall.
The duodenal ulcers are usually located in the area of the transition of the gastric mucosa into the duodenal mucosa in the place where the pyloric sphincter is separated from the circular muscles of the duodenum by the connective tissue layer. It also has the greatest stretching during peristaltic activity. The size of gastroduodenal ulcers can vary from several mm to 50-60 mm in diameter and more. The depth of the ulcers can also be different - from 5 to 20 mm. Ulcers can be round, oval or irregular in shape. The edge of the ulcer facing the entrance to the stomach, as a rule, is undermined, and the mucous membrane hangs over the ulcer defect. The opposite edge is often gently sloping. The folds of the mucous membrane along the periphery of the ulcer are thickened and converge to its edges. Serous membrane in the area of the ulcer is sharply thickened.
Stages of development of the ulcerative process
I - acute stage. An endoscopic examination of an ulcer in this stage is a defect in the mucous membrane of various sizes, shapes and depths. Most often it has a rounded or oval shape, its edges with clear boundaries, hyperemic, edematous. In some cases, the edge facing the cardiac section is somewhat undermined, and the distal edge is more gentle, smoothed. The mucous membrane of the stomach or of the duodenal bulb is edematous, hyperemic, its folds are thickened and poorly straightened with air, often there are punctate erosion, covered with white bloom and often merging into extensive fields. Deep ulcerative defects often have a funnel-shaped appearance. The bottom of the ulcer is usually covered with fibrinous overlays of a grayish-white and yellowish color, the presence of dark patches in the bottom of the ulcer indicates bleeding.
II - stage of subsidence of inflammation. The ulcer defect at this stage is characterized by a decrease in hyperemia and edema of the mucous membrane and inflammatory shaft in the periucerose zone, gradually becoming more flat, may be irregular in shape due to the emerging convergence of the folds of the mucous membrane to the edges of the defect. The bottom of the defect is gradually cleared of fibrinous plaque, while granulation tissue can be found, the ulcer acquires a peculiar appearance, which is described as “pepper with salt” or “salami”. However, a similar pattern is observed at the beginning of the formation of an ulcer. At various stages of healing, the ulcer changes shape into a slit-like, linear or divided into several fragments.
III - cicatrization stage - the ulcer acquires a slit-like shape with slight infiltration and hyperemia around it; on the mucous membrane at a distance from the ulcer there may be areas of slight hyperemia, edema, and isolated erosions.
IV - the stage of the scar The post-ulcerated scar has the appearance of a hyperemic section of the mucous membrane with a linear or stellate depression of the wall (the stage of the "red" scar). In the future, endoscopic examination at the site of the former ulcer determines various disorders of the mucous membrane relief: deformities, scars, narrowing. Most often formed linear and stellate scars. With the healing of deep chronic ulcers or with frequent relapses, gross organ deformities and stenoses can develop. Often, the healing of chronic ulcers can take place without the formation of a visible scar. The mature scar becomes whitish due to the replacement of granulation tissue with connective tissue and the absence of active inflammation (the “white” scar stage). Scars and deformation of the stomach wall and duodenum, resulting from frequent exacerbations of chronic ulcers, are reliable endoscopic criteria for peptic ulcer.
The results of our own research show that the endoscopic method allows for dynamic observation of the process of scarring of the ulcerative defect. On average, the healing of gastric ulcers before the formation of the "red" scar occurs in 6-7 weeks, and duodenal ulcers in 3-4 weeks. The formation of a full-fledged scar usually ends after 2-3 months (the “white” scar phase). It should be borne in mind that acute superficial ulcers can heal within 7-14 days without the formation of a visible scar.
Erosions of the mucous membrane (surface defect that spreads no deeper than the muscular layer of the mucous membrane and heals without scar formation) are often found in peptic ulcer disease and are only diagnosed endoscopically.
Erosions of the distal stomach and duodenal bulb occur in 30-50% of patients with pyloroduodenal ulcers, and in about 75% of patients with exacerbation of peptic ulcer only erosive lesions of this zone are detected.