Abdominal pain in hereditary angioedema: The role of acid hypersecretion

M. J. Collen, J. H. Lewis, W. K. Deschner, A. F. Ansher, John Zurlo, S. B. Benjamin, M. M. Frank

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Hereditary angioedema is a familial disorder characterized by recurrent episodes of soft tissue swelling and abdominal pain. Whereas most patients are successfully treated with androgenic steroids, some have abdominal pain unresponsive to therapy. To determine whether acid-peptic disease could account for the abdominal pain unresponsive to androgen therapy, we performed upper gastrointestinal endoscopy and determined basal acid output in 21 consecutive patients with hereditary angioedema and abdominal pain. Mean basal acid output of this group was 6.0 ± 5.9 mEq/h, with five patients having gastric acid hypersection (defined as a basal acid output of greater than 10.0 mEq/h). The abdominal pain in 18 responded to stanozolol, whereas the pain in three patients did not change. Acid-peptic mucosal disease (esophagitis or duodenal ulcer) was present in these three patients with abdominal pain unresponsive to androgen therapy, all of whom had gastric acid hypersecretion (basal acid outputs of 13.7, 19.1, and 21.5 mEq/h, respectively). These three patients were treated with ranitidine but required increased doses to control their gastric acid hypersecretion, and to promote complete relief of abdominal pain and healing of their esophagitis or ulcer disease. These results indicate that there is a subset of patients with hereditary angioedema whose abdominal pain may be secondary to acid-peptic disease and gastric acid hypersecretion. Such individuals may require increased therapeutic doses of antisecretory medication to promote complete healing of esophagitis or ulcer disease. Basal acid output and upper gastrointestinal endoscopy are important determinants when evaluating abdominal pain in patients with hereditary angioedema that fails to respond to standard therapy.

Original languageEnglish (US)
Pages (from-to)873-877
Number of pages5
JournalAmerican Journal of Gastroenterology
Volume84
Issue number8
StatePublished - Jan 1 1989

Fingerprint

Hereditary Angioedemas
Abdominal Pain
Acids
Gastric Acid
Esophagitis
Digestion
Gastrointestinal Endoscopy
Androgens
Ulcer
Stanozolol
Nociceptive Pain
Therapeutics
Ranitidine
Duodenal Ulcer
Steroids
Pain

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology

Cite this

Collen, M. J., Lewis, J. H., Deschner, W. K., Ansher, A. F., Zurlo, J., Benjamin, S. B., & Frank, M. M. (1989). Abdominal pain in hereditary angioedema: The role of acid hypersecretion. American Journal of Gastroenterology, 84(8), 873-877.
Collen, M. J. ; Lewis, J. H. ; Deschner, W. K. ; Ansher, A. F. ; Zurlo, John ; Benjamin, S. B. ; Frank, M. M. / Abdominal pain in hereditary angioedema : The role of acid hypersecretion. In: American Journal of Gastroenterology. 1989 ; Vol. 84, No. 8. pp. 873-877.
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Collen, MJ, Lewis, JH, Deschner, WK, Ansher, AF, Zurlo, J, Benjamin, SB & Frank, MM 1989, 'Abdominal pain in hereditary angioedema: The role of acid hypersecretion', American Journal of Gastroenterology, vol. 84, no. 8, pp. 873-877.

Abdominal pain in hereditary angioedema : The role of acid hypersecretion. / Collen, M. J.; Lewis, J. H.; Deschner, W. K.; Ansher, A. F.; Zurlo, John; Benjamin, S. B.; Frank, M. M.

In: American Journal of Gastroenterology, Vol. 84, No. 8, 01.01.1989, p. 873-877.

Research output: Contribution to journalArticle

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Collen MJ, Lewis JH, Deschner WK, Ansher AF, Zurlo J, Benjamin SB et al. Abdominal pain in hereditary angioedema: The role of acid hypersecretion. American Journal of Gastroenterology. 1989 Jan 1;84(8):873-877.