gastrins and aluminum-hydroxide--magnesium-hydroxide--drug-combination

Acid secretory responses and parietal cell sensitivity (PCS) have been studied in 21 duodenal ulcer patients before and after successful treatment with omeprazole (n = 7), sucralfate (n = 7), or Maalox (n = 7). The second study was carried out 3 days after documented healing and withdrawal of treatment in the sucralfate- and Maalox-treated groups and 14 days after documented healing and withdrawal of treatment in the omeprazole-treated patients. Acid output (mmol/hour) was measured as basal secretion, and in response to 0.1 microgram/kg/hour pentagastrin (low-dose) and 6.0 micrograms/kg/hour pentagastrin (high-dose) stimulation. PCS was calculated as the ratio of low dose:high dose acid output (expressed as a percentage). Ulcer healing with sucralfate resulted in significant (p less than 0.05) decreases in low-dose acid output from 36.4% (13.2-51.0) (median [range]) to 8.4% (3.2-45.4) mmol/hour and PCS from 69.1% (44.9-91.4) to 22.0% (16.0-85.6), whereas no significant decreases in any of the measured parameters were noted following ulcer healing with Maalox. Ulcer healing with omeprazole resulted in significant (p less than 0.05) decreases in basal acid output from 6.3 (1.5-22.9) (median [range]) to 2.2 (0-6.9) mmol/hour, and low-dose acid output from 31.0 (6.0-58.0) to 23.0 (1.4-44.8) mmol/hour. These findings suggest that acid secretory responses following ulcer healing vary according to the therapeutic agent used.

Topics: Adult; Aged; Aluminum Hydroxide; Antacids; Drug Combinations; Duodenal Ulcer; Endoscopy, Gastrointestinal; Fasting; Female; Gastric Acid; Gastric Acidity Determination; Gastrins; Humans; Magnesium Hydroxide; Male; Middle Aged; Omeprazole; Parietal Cells, Gastric; Pentagastrin; Recurrence; Sucralfate; Wound Healing

The effect of long-term administration of an antacid preparation on the gastric mucosa was investigated in rats, special attention was directed towards hypergastrinaemia and density of argyrophil cells. One ml of an Al (OH)3- and Mg (OH)2-containing antacid (in vitro neutralization capacity 28 mmol/die) or water was administered intragastrically 4 times daily. An additional group of rats remained untreated. Twelve hours after the final dose serum gastrin levels were significantly (p less than 0.001) elevated (113 +/- 28 pg/ml) compared to the control groups (33 +/- 1 and 22 +/- 2 pg/ml). Antral gastrin (G)-cell density was also increased after antacids by 58% whereas the somatostatin (D)-cell density and the somatostatin concentration in antral tissues were decreased. The number of fundic D- and argyrophil cells were not altered by antacid treatment. The number of parietal cell declined significantly in response to antacids. The foveolar gland region was almost doubled after antacids. It is concluded that in the rat 1. despite persistent hypergastrinaemia due to chronic antacid administration increases in argyrophil cell densities are not to be found; 2. long-term administration of antacids exert a trophic effect on the corpus mucosa predominantly by an increase of mucus neck cells.

Topics: Aluminum Hydroxide; Animals; Antacids; Drug Combinations; Enterochromaffin Cells; Gastric Mucosa; Gastrins; Long-Term Care; Magnesium Hydroxide; Male; Parietal Cells, Gastric; Peptides; Rats; Rats, Inbred Strains

The neutralizing capacity of two antacids (Alucol = A, Syntrogel = S), differing both in their composition and theoretical neutralizing capacity, was evaluated in vitro and in vivo. In vitro at pH 3.5, 1 ml of A or S neutralizes 3.9 and 1.6 meq of acid, respectively, in an aqueous solution. When tested in vivo in the absence of food during near maximal acid secretion, induced by impromidine, 60 ml of either A or S reduced the 4-hr mean H+ activity by 83% and 65%, respectively. In contrast, the reduction of the 12-hr H+ activity observed after repeated administration of 30-60 ml of A or S at the end of the postprandial hour failed to reach significance with both preparations. This suggests that interaction with food produces a considerable loss of in vivo antacid neutralizing capacity, not quantitatively predictable from in vitro tests.

Topics: Adult; Aluminum Hydroxide; Antacids; Calcium; Calcium Carbonate; Drug Combinations; Female; Food; Gastric Acidity Determination; Gastric Juice; Gastrins; Humans; Hydrogen-Ion Concentration; Imidazoles; Impromidine; Magnesium; Magnesium Hydroxide; Male; Secretin