magnesium-trisilicate and Stomach-Ulcer

Formation of calculi in efferent urinary passages is always due to supersaturation of urinary calculi substances and associated increased crystallization. Apart from the typical calculi, consisting of calcium oxalate, inorganic phosphates, uric acid or cystine, there are occasional signs of rare substance classes. Although more than 50 silicate stones have already been reported internationally, this stone entity remains relatively unknown. In particular, the occurrence of silicate stones in the absence of magnesium trisilicate abuse is extremely rare. A medium-sized left-sided ureterolith was removed from a 54-year-old male patient using a ureteroscope. X-ray diffraction showed it to be a compound stone consisting of 40% silicate. The patient, who in 1986 was living close to the nuclear reactor accident in Chernobyl, showed no signs of a constant uptake of magnesium trisilicate. However, he had undergone partial (2/3) gastrectomy 4 months before for a drug-refractory gastric ulcer, which had been diagnosed at the end of the 1980s and treated with excessive dosages of a magnesium trisilicate antacid preparation until the time of the operation. The patient had also been suffering from unstable angina pectoris since 1986 and treated with Pentalong (pentaerythrityltetranitrate) for 17 years. We were also able to detect silicium dioxide in components of this drug using X-ray diffraction. Silicate uroliths are extremely rare but they can be clearly identified by X-ray diffraction or infrared spectroscopy and distinguished from artifacts or quartz pebbles. Formation of calculi can be prevented by increasing diuresis as well as switching to a different drug and reducing the dosage.

Topics: Angina, Unstable; Crystallography, X-Ray; Gastrectomy; Humans; Long-Term Care; Magnesium Silicates; Male; Middle Aged; Pentaerythritol Tetranitrate; Silicon Dioxide; Stomach Ulcer; Ureteral Calculi; Ureteroscopy

In three groups of six patients with gastric ulcer, sucralfate, aluminium hydroxide and magnesium trisilicate, respectively was applied to the ulcer under endoscopic vision. Prior to, two and four hours after application of these substances, the transmural electrical potential difference (p.d.) was measured in the region of the bed of the ulcer, the margin of the ulcer, the antrum on the lesser curvature side, and in the pool of juice; additionally, the degree of adherence of the substances to the floor of the ulcer was recorded. After sucralfate, the increase in p.d. in the bed of the ulcer was clearly greater two and four hours post-application than after the two antacids tested, and adherence to the ulcer was also more marked and longer lasting. These findings confirm the superior local protective effect of sucralfate in the bed of the ulcer on the basis of its physico-chemical properties, as compared with the antacids tested. These clinico-experimental findings correlate with the efficacy of sucralfate in ulcer disease as demonstrated in clinical studies.

Topics: Action Potentials; Administration, Topical; Aluminum; Aluminum Hydroxide; Antacids; Gastric Juice; Gastric Mucosa; Gastroscopy; Humans; Magnesium; Magnesium Silicates; Silicic Acid; Stomach Ulcer; Sucralfate