ANERDIC

Peptic Ulcer

Mechanism of Action

Prescribing Information

Patient Information

Anerdic in the World

:: Peptic Ulcer ::

Data Statistic and Facts

Peptic ulcer is a disease caused by imbalanced factors that leads to mucosal damage, such as gastric acid, pepsin, mucus, bicarbonate, prostaglandin, mucosal blood flow, infection of H. pylori, and NSAID use.1 It was estimated that approximately 5-10% of adults in the world have experienced peptic ulcer at least once in their life.2 In 2008, the prevalence of peptic ulcer in various countries around the world varied greatly, starting from 30% in developed countries to 80% in developing countries.

What is Peptic Ulcer?

Peptic ulcer is a condition in which a disruption of gastric mucosa integrity, duodenum, or both, causes local inflammation. This inflammation results from the inability of the mucosa to protect the stomach and duodenum from acid and pepsin imbalance.
The main cause of peptic ulcer is Helicobacter pylori (H. pylori) infection and anti-inflammatory drugs (NSAID) use. H. pylori is a gram negative bacteria that live in acidic condition in the stomach/duodenum. It is usually found in the gastric mucous layer or attached to the gastric epithelium lining. Nearly 90% of duodenum ulcers and 80% of gastric ulcers cases are caused by H. pylori,3 but only about 15-20% of individuals infected by H. pylori will develop peptic ulcer.4 H. pylori infection will cause:

  • Abnormalities of acid secretion in duodenum and chronic inflammation, thereby disrupting the regulation of parietal cells inhibition and leads to enhancement of acid. In patient with ulcers, the production of gastric acid can reach 40 mEq/hour, while the normal production of gastric acid is 20 mEq/hour.
  • Induction of inflammatory reaction which reduces bicarbonate secretion by duodenal epithelial tissue. It reduces the ability of duodenum mucosa to detain caustic effects from gastric.

The use of NSAIDs can also damage the gastrointestinal tract (GI), mainly due to the suppression of gastric prostaglandin production.1 The side effects from using NSAIDs appear along with the inhibition of cyclooxygenase enzyme (COX) which leads to the inhibition of prostaglandin synthesis from arachidonic acid. Decrease in COX enzymes is in line with decrease of gastric haemostatic function. This results in decrease of mucus and bicarbonate production, making the gastric epithelium more susceptible to damage caused by hydrochloric acid and pepsin.
Other factors that may increase the risk of peptic ulcer are:

  • Smoking, which decreases the production of gastric prostaglandin and bicarbonate  secretion.
  • Alcohol consumption that may increase gastric acid secretion and gastric mucosal permeability.
  • Stress
  • Cocaine

What are the symptoms of Peptic Ulcer?

The most common symptoms of peptic ulcer are gnawing and burning pain in the epigastrium.3 These symptoms usually appear when the stomach is in empty condition, but can also appear in other times. Other symptoms that might appear including nausea, vomiting, flatulence, loss of appetite, weight loss, anemia, and in worst case it can result in bleeding.3,5
Gastric ulcer and duodenum ulcer generally have similar symptoms, but there is a slight difference between the two. Gastric ulcer usually occurs with pain in the abdomen area immediately after a person eats, while duodenum ulcer appears when the stomach is empty. People with duodenum ulcer will often wake up at night with pain, due to excessive amount of acid produced in the night.

How to detect Peptic Ulcer?

To detect and diagnose peptic ulcer, doctor will offer several tests that consist of:3

  • Radiological tests, where the test is performed to confirm the diagnosis of peptic ulcer.
  • Endoscopic tests, with this test the doctor can determine whether the ulcer is malignant or benign and can ensure the presence of bacteria H. pylori as the cause of ulcers.
  • Invasive tests, such as Rapid Urea Test is a colorimetric test based on the ability of bacteria H. pylori to hydrolyze urea by looking at the color and pH changes that occur. Invasive test also consists of histological and culture test.
  • Non-invasive test, such as Urea Breath Test is a test to detect the presence of H. pylori infection by using the urea that is produced by H. pylori.

What are the risks and complications of Peptic Ulcer?

People with peptic ulcer that is caused by H. pylori infection, have higher risk of gastric cancer and mucosal-associated-lymphoid-type (MALT) lymphoma (two to six times higher than uninfected people).
Complications that often occur in peptic ulcer are:

  • Bleeding, experienced by approximately 15-20% of patients with peptic ulcer, if left untreated it might lead to death.
  • Peritonitis, as a result of perforation in stomach.
  • Obstruction, such as stomach outlet obstruction due to the conformation of fibrosis or edema and spasm.

How to prevent Peptic Ulcer?

There are several ways to prevent peptic ulcer, which are:

  • Keep the surrounding environment clean to avoid H. pylori infection.
  • Minimize the use of NSAID drugs.
  • Lifestyle changes, including reduced consumption of spicy food and caffeine, smoking, and alcohol consumption.
  • Avoid excessive stress.

How to treat Peptic Ulcer?

Patients with peptic ulcer will be treated with several medications, among others:

  • If the peptic ulcer is caused by H. pylori bacteria, antibiotics will be used to eliminate the infection.
  • The use of drugs that act as “proton pump inhibitor”, which useful to reduce the amount of stomach acid.

Anerdic

Anerdic contains DLBS2411, a bioactive fraction from Cinnamomum burmannii that is effective to treat peptic ulcer. Anerdic works as an anti-ulcer agent through its mechanism of action that regulates proton pump and proton pump inhibitors by inhibiting the activity of H+/K+/ATPase enzyme. It also works as a mucoprotector. Furthermore, Anerdic is effective for treatment of GERD (Gastroesophageal reflux disease).

 

Source:

1. Clinical Key Elsevier. Peptic Ulcer Disease. https://www.clinicalkey.com/topics/gastroenterology/peptic-ulcer-disease.html

2. Medical News Today. What Is a Peptic Ulcer? What Causes Peptic Ulcers? http://www.medicalnewstoday.com/articles/9273.php

3. Centers for Disease Control and Prevention (CDC). Helicobacter pylori. Fact Sheet for Health Care Providers. July 1998.

4. Dr. Guarner, Lazaro, Gascon, Royo, Dr. Eximan, Dr. Herrero. Map of Digestive Disorders & Diseases 2008.

5. Duodenal and Gastric Ulcers: Symptoms and Treatment. http://voices.yahoo.com/duodenal-gastric-ulcers-symptoms-treatment-2074961.html?cat=68

:: Mechanism of Action ::

Anerdic is a bioactive fraction that has anti-ulcer property. It works by inhibiting the activity of H+/K+ ATPase enzyme, an enzyme that regulates proton pump in the stomach. Inhibition of this enzyme could inhibit excessive gastric acid secretion.
Anerdic is an effective option for patients with excessive gastric acid problem, in addition it also acts as mucoprotector.

:: Precribing Information ::

Composition:

Each capsule contains:

Bioactive fraction DLBS2411Cinnamomum burmannii 250 mg.

Usage:

Helps to alleviate gastric disorders.

Warning and Precaution

During treatment, consult your doctor regularly.

Side effects

No side effects have been recorded during the toxicological and clinical studies. Anerdic is considered safe if taken at the recommended dosage.

If you experience any side effect that might be caused by Anerdic, call your doctor as soon as possible.

Packaging and Registration No

Box, 5 strips @ 6 caplets, POM HT. 132 500 351

:: Patient Information ::

What is Anerdic?
Anerdic is a bioactive fraction that has anti-ulcer property, which works by inhibiting the activity of H+/K+ ATPase enzyme, an enzyme that regulates proton pump in the stomach. The inhibition of this enzyme would lead to the reduction of excessive gastric secretion.
Anerdic is an effective option for patients with excessive gastric acid. In addition it also acts as mucoprotector.


Contraindication in taking Anerdic
You should not take Anerdic if you are allergic to any of its components.


How should I take Anerdic?
Anerdic can be taken 1-2 times a day orally. However, dosage can be adjusted to your doctor’s instructions.
You may take Anerdic before or after a meal.


What happens if I missed a dose?
If you missed taking a dose of Anerdic, take it as soon as you remembered. Skip the missed dose if it is almost time for your next scheduled dose. Do not take an extra caplet to make up for the missed dose.


What should I do while taking Anerdic?

  • Have a regular and balanced healthy diet that consists of nutritious food.
  • Avoid spicy and acidic food which can lead to enhanced acid production in the stomach. Avoid drinking alcohol and smoking.
  • Have enough rest and avoid excessive stress.

 

Anerdic side effects
No side effects have been recorded during the toxicological studies. Anerdic is considered safe if taken at the recommended dosage.
If you experience any side effect that might be caused by Anerdic, consult your doctor immediately.


Interaction of Anerdic with other drugs
There is no study regarding drug interaction of Anerdic with other medicines.


What should I tell my doctor/pharmacist?
Always tell your doctor / pharmacist

  • If you are taking any other medicines or food supplements;
  • If you have any allergy.
  • Women should tell their doctor / pharmacist if they are pregnant or planning to get pregnant.

 

What storage conditions are needed for Anerdic?
Anerdic must be stored at a temperature below 30°C.

It must be protected from light and out of reach of children.
 

:: Anerdic in the World ::

Anerdic has been registered to the Food and Drug Administration of the Philippines and currently awaiting for approval.
Our goal is to offer the possibility for patients throughout the world to have access to Anerdic.
If you are interested in partnering with us, please see the partnership page in this website or contact us directly.