The aim of this study was the effect of
antacids containing inorganic
bismuth compounds on the morphology of the gastric mucosa and healing of the
duodenal ulcer (DU) in patients with exacerbation of the
ulcer disease. 169 patients were treated for four weeks with low-dose
antacids (two drugs containing
bismuth subnitrate--
Gastrin and Wikalina, with buffering capacity below 200 mmol HCl per day) and for comparison with
ranitidine,
colloidal bismuth subcitrate and placebo. We evaluated the effect of these drugs on the morphology of gastric mucosa using endoscopic, histologic and morphometric methods, as well as healing of DU,
ulcer symptoms and drug tolerance.
Antacids and
colloidal bismuth subcitrate decreased both the chronic active
gastritis of praepyloric region and frequency of
Helicobacter infection, however without the full eradication.
Antacids,
ranitidine and
colloidal bismuth subcitrate did not affect the height of surface epithelium, thickness of foveolar and glandular mucosa as well as the number and size of parietal cells, thus they were without any trophic effects on the gastric mucosa. All mentioned drugs healed DU in 68-73% of patients and significantly better than placebo (46%). These drugs were well tolerated by patients, however
antacids caused slight increase in pH of urine and transient hipermagnesemia. Because the etiopathogenese of
ulcer disease is still unclear, its
therapy is unsuccessful in many cases. We should stress that the treatment with
antacids in some cases can be a good and safe alternative
therapy in spite of many other currently used medications.