Effect of sucralfate on aspirin induced mucosal injury and impaired haemostasis in humans.
BACKGROUND
Sucralfate does not have potent anti-ulcerogenic actions in users of non-steroidal anti-inflammatory drugs (NSAIDs). However, sucralfate may influence intragastric haemostasis favourably.


OBJECTIVE
To investigate separately the effects of sucralfate on acute gastric and duodenal injury and on changes in intragastric bleeding induced by aspirin.


METHODS
On three occasions, 24 healthy volunteers received three days' treatment with aspirin 900 mg twice daily together with placebo, sucralfate 2 g twice daily or sucralfate 1 g four times daily. Injury was assessed endoscopically and bleeding by spontaneous and biopsy induced bleeding intragastric washings. Ex vivo prostaglandin E2 (PGE2) synthesis and serum thromboxane were measured by using radioimmunoassay.


RESULTS
Aspirin significantly inhibited ex vivo gastric mucosal PGE2 synthesis, reduced serum thromboxane, caused gastric erosions, and increased spontaneous and biopsy induced bleeding. Sucralfate had no significant effects on endoscopic injury but sucralfate 1 g four times daily significantly reduced spontaneous and biopsy induced bleeding. Similar trends were seen with sucralfate 2 g twice daily but the results were less consistent.


CONCLUSIONS
Sucralfate does not affect aspirin induced acute gastric mucosal injury but reduces aspirin associated intragastric bleeding.
Hudson
N
N
Division of Gastroenterology, University Hospital, Nottingham.
Murray
F E
FE
Cole
A T
AT
Filipowicz
B
B
Hawkey
C J
CJ
D000208:Acute Disease; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D000897:Anti-Ulcer Agents / Q000627:therapeutic use*; D001241:Aspirin / Q000009:adverse effects*; D001706:Biopsy / Q000009:adverse effects; D018592:Cross-Over Studies; D015232:Dinoprostone / Q000096:biosynthesis; D004311:Double-Blind Method; D005753:Gastric Mucosa / Q000187:drug effects / Q000378:metabolism; D006471:Gastrointestinal Hemorrhage / Q000139:chemically induced / Q000188:drug therapy* / Q000378:metabolism; D006487:Hemostasis; D006801:Humans; D013392:Sucralfate / Q000627:therapeutic use*; D013931:Thromboxanes / Q000097:blood
D000894:Anti-Inflammatory Agents, Non-Steroidal; D000897:Anti-Ulcer Agents; D013931:Thromboxanes; D013392:Sucralfate; D015232:Dinoprostone; D001241:Aspirin