Sucralfate suppresses Helicobacter pylori infection and reduces gastric acid secretion by 50% in patients with duodenal ulcer.
OBJECTIVE
The mechanism(s) by which sucralfate heals duodenal ulcers remains unclear. The aim of this study was to determine the effect of sucralfate on Helicobacter pylori infection and on the accompanying hypersecretion of gastric acid the infection induces in patients with duodenal ulcer.


METHODS
Basal and gastrin-releasing peptide (GRP) stimulated gastrin release and acid secretion. H. pylori density, gastric urease activity, and severity of gastritis were studied in patients with duodenal ulcer who were positive for H. pylori before, during, and after 4 weeks' treatment with sucralfate (2 g twice daily).


RESULTS
The density of H. pylori decreased by 70% during sucralfate treatment and returned to the pretreatment level after discontinuation of therapy. This suppression of H. pylori infection was accompanied by an 80% decrease in gastric urease activity. GRP-stimulated plasma gastrin concentrations, GRP-stimulated acid output, and basal acid output all decreased by approximately 50% during sucralfate therapy and returned to pretreatment levels after treatment was discontinued.


CONCLUSIONS
These findings indicate that sucralfate markedly suppresses H. pylori infection and the accompanying hypersecretion of acid the infection induces in patients with duodenal ulcer. These effects are likely to be important mechanisms by which the drug promotes duodenal ulcer healing.
Banerjee
S
S
Gastrointestinal Centre, Southern General Hospital, Glasgow, Scotland.
El-Omar
E
E
Mowat
A
A
Ardill
J E
JE
Park
R H
RH
Watson
W
W
Beattie
A D
AD
McColl
K E
KE
D000328:Adult; D000368:Aged; D000897:Anti-Ulcer Agents / Q000627:therapeutic use*; D001944:Breath Tests; D004381:Duodenal Ulcer / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D005744:Gastric Acid / Q000378:metabolism*; D005753:Gastric Mucosa / Q000187:drug effects / Q000378:metabolism / Q000382:microbiology; D019886:Gastrin-Releasing Peptide; D005755:Gastrins / Q000097:blood; D005756:Gastritis / Q000209:etiology / Q000473:pathology; D016481:Helicobacter Infections / Q000150:complications / Q000188:drug therapy* / Q000382:microbiology; D016480:Helicobacter pylori / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008875:Middle Aged; D010455:Peptides / Q000494:pharmacology; D013270:Stomach / Q000201:enzymology / Q000473:pathology; D013392:Sucralfate / Q000627:therapeutic use*; D014510:Urease / Q000378:metabolism
D000897:Anti-Ulcer Agents; D005755:Gastrins; D010455:Peptides; D013392:Sucralfate; D019886:Gastrin-Releasing Peptide; D014510:Urease