Absorption of bismuth from two bismuth compounds before and after healing of peptic ulcers.
OBJECTIVE
Previous reports state that there is absorption of bismuth through active peptic ulcers. It was therefore of interest to investigate the extent of absorption in patients at the ulcer and post-ulcer stages.


METHODS
Twenty H. pylori-positive patients with gastroscopically verified gastric or duodenal ulcers were randomly allocated to ingest 3000 mg bismuth subnitrate (BSN) (10 patients) or 480 mg colloidal bismuth subcitrate (CBS) (10 patients). Bismuth serum concentration in 12 samples drawn during the first 4 hours after drug intake was analyzed and the area under the curve (Bi-AUC) was calculated. Anti-H. pylori therapy with amoxicillin and lanzoprazole eradicated H. pylori in 10 patients and healed the ulcers in all patients 4 weeks after therapy ended, then the bismuth absorption test was repeated.


RESULTS
There was no significant difference between ulcer- and post-ulcer Bi-AUC for patients receiving BSN or for patients receiving CBS. On a molar basis, CBS gave a 17.4-fold greater absorption of bismuth compared to BSN.


CONCLUSIONS
The presence of an active ulcer does not significantly influence the absorption of bismuth from CBS or BSN.
Hundal
O
O
The Pharmacy, University of Bergen, Norway. oivind.hundal@haukeland.no
Bergseth
M
M
Gharehnia
B
B
Andersen
K J
KJ
Berstad
A
A
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000897:Anti-Ulcer Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D001729:Bismuth / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics*; D005260:Female; D016481:Helicobacter Infections / Q000097:blood / Q000188:drug therapy*; D016480:Helicobacter pylori / Q000187:drug effects; D006801:Humans; D007408:Intestinal Absorption / Q000187:drug effects / Q000502:physiology; D008297:Male; D008875:Middle Aged; D009942:Organometallic Compounds / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D010437:Peptic Ulcer / Q000097:blood / Q000188:drug therapy*; D016896:Treatment Outcome; D014945:Wound Healing / Q000187:drug effects* / Q000502:physiology
D000897:Anti-Ulcer Agents; D009942:Organometallic Compounds; C010804:bismuth subnitrate; C002791:bismuth tripotassium dicitrate; D001729:Bismuth