title: Acid-secretory response and parietal cell sensitivity in patients with duodenal ulcer before and after treatment with sucralfate or ranitidine.
abstract: Patients with endoscopically proved duodenal ulcer were randomly assigned to treatment with either ranitidine 300 mg at bedtime or sucralfate 2 g twice daily for six weeks. Acid-secretory studies were performed before commencement and 60 to 84 hours after cessation of treatment and endoscopic healing was confirmed. Patients were randomly assigned to receive a constant infusion of secretory stimulant: either pentagastrin 0.1 and 6.0 micrograms/kg/hour or histamine acid phosphate 4.0 and 40 micrograms/kg/hour. Acid output in mmol/hour was measured for basal, low dose, and high dose output. Parietal cell sensitivity (PCS) was calculated as the ratio of low-dose acid output: high-dose acid output and expressed as a percentage. Values before and after treatment were compared and significance of differences was determined using the Student paired t test. There was an apparent decrease in basal acid output, low-dose acid output, high-dose acid output, and PCS with ulcer healing, regardless of treatment or stimulant used. Basal acid output, low-dose acid output, high-dose acid output, and PCS were significantly lower in the sucralfate-treated group, but only high-dose acid output decreased significantly in the ranitidine-treated group. These differences may be relevant to early duodenal ulcer relapse in ranitidine-treated patients.
authors.affiliation: Department of Medicine, University of Cape Town, South Africa.
authors.forename: I N
authors.initials: IN
authors.lastname: Marks
authors.forename: G O
authors.initials: GO
authors.lastname: Young
authors.forename: N A
authors.initials: NA
authors.lastname: Tigler-Wybrandi
authors.forename: S
authors.initials: S
authors.lastname: Bridger
authors.forename: K A
authors.initials: KA
authors.lastname: Newton
mesh_terms: D000293:Adolescent; D000328:Adult; D004381:Duodenal Ulcer / Q000188:drug therapy* / Q000378:metabolism; D005260:Female; D005744:Gastric Acid / Q000378:metabolism*; D006632:Histamine / Q000031:analogs & derivatives / Q000494:pharmacology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010295:Parietal Cells, Gastric / Q000187:drug effects / Q000378:metabolism*; D010418:Pentagastrin / Q000494:pharmacology; D011899:Ranitidine / Q000627:therapeutic use*; D013392:Sucralfate / Q000627:therapeutic use*
chemical_list: D013392:Sucralfate; D006632:Histamine; D011899:Ranitidine; D010418:Pentagastrin; C027556:histamine phosphate