simethicone and Duodenal-Ulcer

This study was conducted using roxatidine acetate or Mylanta combined with metronidazole and amoxicillin to evaluate the role of acid and Helicobacter pylori in the natural course of the duodenal ulcer. Eighty-three patients with H. pylori positive duodenal ulcers were randomly allocated into one of four treatment groups. Group A: roxatidine 75 mg hs for 8 weeks; Group B: the same as group A + metronidazole 250 mg and amoxicillin 250 mg qid for 1 week on the 3rd week; Group C: Mylanta (combined hydroxide of magnesium and aluminum) 20 ml qid for 8 weeks; Group D: the same as group C + metronidazole 250 mg and amoxicillin 250 mg qid for 1 week on the 3rd week. Repeated endoscopies were performed on the 8th week post the initial treatment and the sixth and 12th month post the termination of treatment, or, at the earliest recurrence of symptoms. Eradication of H. pylori was considered to be successful if the culture, histology and CLO test all showed negative. The ulcer healing rates of Groups A, B, C and D were 95%, 100%, 61% and 86%, respectively, with a significant difference between A and C. The eradication rates of groups B and D were 81% and 62%, respectively, without any significant difference. The 12 months cumulative ulcer recurrence rates were 72%, 15%, 80% and 22%, respectively, with a significant difference between each paired groups with and without antibiotics. In conclusions, roxatidine is effective in the healing of duodenal ulcer. One-week roxatidine-based triple therapy is powerful in the eradication of H. pylori. Potent acid suppression is sufficient to heal the duodenal ulcer. Eradication of H. pylori can potentiate ulcer healing under insufficient acid suppression. A causal role for H. pylori in recurrent duodenal ulcer is strongly supported by a much lower recurrence of ulcer in H. pylori free patients.

Topics: Adolescent; Adult; Aged; Aluminum Hydroxide; Drug Combinations; Duodenal Ulcer; Female; Gastric Acid; Helicobacter pylori; Humans; Magnesium Hydroxide; Male; Middle Aged; Piperidines; Prospective Studies; Recurrence; Simethicone

The foreign-made drug preparation maldroxal the formulation of which includes aluminium hydroxide, magnesia hydroxide and dimeticon, is an effective medicine making for the instant relief of pain and dyspeptic syndromes; it is capable of exerting an antiinflammatory effect. It has also been ascertained that maldroxal fails to influence much the elimination of H. p., which fact necessitates an additional prescription of antibacterial drugs.

Topics: Adult; Aluminum Hydroxide; Antacids; Chronic Disease; Drug Combinations; Drug Therapy, Combination; Duodenal Ulcer; Duodenitis; Female; Gastritis; Helicobacter Infections; Helicobacter pylori; Humans; Magnesium Hydroxide; Male; Middle Aged; Simethicone

This study was designed to compare the rates of duodenal ulcer healing and recurrence after treatment with cimetidine or antacid. Patients with endoscopically documented duodenal ulcer received cimetidine, 1200 mg daily, or Mylanta II, 7 oz daily, in a randomized, double-blind trial. For the 69 patients in each group who completed the healing phase of the trial, endoscopic ulcer healing was almost identical. At 2, 4, and 6 wk, the cumulative percent healed on antacid was 33%, 64%, and 80%, and on cimetidine it was 25%, 62%, and 86%. The 114 patients with healed ulcer were observed on no therapy and underwent additional endoscopy to detect recurrences when symptomatic or at 3, 6, and 12 mo. There was no difference in the frequency of recurrences between treatments. At 3 and 6 mo, the cumulative percentages of patients with recurrence were 29% and 56% after antacid therapy and 36% and 55% after cimetidine therapy. Some patient variables were associated with delayed ulcer healing or ulcer recurrence. These included sex, pain frequency, smoking, disease duration, and acid secretion.

Topics: Aluminum Hydroxide; Antacids; Cimetidine; Clinical Trials as Topic; Double-Blind Method; Drug Combinations; Duodenal Ulcer; Female; Guanidines; Humans; Magnesium; Magnesium Hydroxide; Male; Middle Aged; Recurrence; Silicones; Simethicone

Fifty consecutive patients with symptomatic endoscopically proven duodenal ulcer were randomized double-blind to Mylanta II or cimetidine treatment schedules. Smoking habits were noted, but patients were not advised to alter these. Healing was determined by reendoscopy at 6 wk. Eighty percent of patients on active cimetidine and 52% on active Mylanta II had healed at 6 wk (not significantly); 85% of nonsmokers healed compared to 44% of smokers (p less than 0.03). In smokers, cimetidine achieved healing in 50%, Mylanta II in 39% (not significantly); while in nonsmokers, cimetidine achieved healing in 100%, Mylanta II in 67% (not significantly). These results indicate a significant and equally adverse effect of smoking on the healing rate of duodenal ulcer achieved by either cimetidine or Mylanta II.

Topics: Adolescent; Adult; Aged; Aluminum Hydroxide; Antacids; Cimetidine; Diarrhea; Double-Blind Method; Drug Combinations; Duodenal Ulcer; Female; Guanidines; Humans; Magnesium; Magnesium Hydroxide; Male; Middle Aged; Random Allocation; Silicones; Simethicone; Smoking

The effect of cimetidine (400 mg twice a day) on the short-term healing of chronic peptic ulcer is reported. In benign gastric ulcer, 17 of 25 patients (68%) healed in six weeks and 23 of 25 patients (92%) by 12 weeks. In duodenal ulcer, 33 of 42 patients (80%) healed in six weeks and 40 of 42 patients (95%) by 12 weeks. In stomal ulcer after a previous Polya gastrectomy, eight of 10 patients (80%) healed in six weeks and 10 of 10 patients (100%) by 12 weeks. In this study, the cimetidine regimen of 400 mg twice a day has produced healing rates in gastric, duodenal or stomal ulcer which compare favourably with those reported for the currently recommended regimen of 200 mg three times a day and 400 mg at night. Twice a day dosage is likely to improve patient compliance, costs less, and may reduce dose-related side effects. Perhaps 400 mg of cimetidine twice a day should become the recommended dosage for the initial treatment of peptic ulcer.

Topics: Adult; Aged; Aluminum Hydroxide; Antacids; Cimetidine; Drug Combinations; Duodenal Ulcer; Endoscopy; Female; Gastrectomy; Guanidines; Humans; Magnesium Hydroxide; Male; Middle Aged; Patient Compliance; Peptic Ulcer; Simethicone; Time Factors; Ulcer