Treatment of the gastric stump ulcer: an open study with five drugs.
OBJECTIVE
Despite a great progress in the treatment of peptic ulcer disease, the management of gastric stump ulcers still remains to be established.


METHODS
Eighty-one patients with peptic ulcer developed postoperatively in the gastric remnant were treated in an open trial with 5 antiulcer drugs (cimetidine, omeprazole, sucralfate, colloidal bismuth and misoprostol) characterized by different mechanisms of action. The ulcer healing rate was evaluated endoscopically after 2, 4 and 6 weeks.


RESULTS
It was found that after 2 weeks the most rapid ulcer healing was in the omeprazole and cimetidine treated groups, 67 and 43% of healing, respectively. Also after 4 weeks the antisecretors were more effective than gastroprotective drugs; ulcer healing rate for omeprazole was 87% and cimetidine 68%, while for sucralfate, colloidal bismuth and misoprostol 50%, 52%, and 33%, respectively. After 6 weeks all drugs represented very close ulcer healing rates.


CONCLUSIONS
Both antisecretory and gastroprotective drugs may be useful in the management of stump ulcers, however, to initiate and accelerate the stump ulcer healing omeprazole appears to be the drug of choice.
Janke
A
A
III Department of Medicine and Gastroenterology, J. Sniadecki's District Hospital, Poland.
Stasiewicz
J
J
Namiot
Z
Z
Szalaj
W
W
D000328:Adult; D000368:Aged; D000863:Antacids / Q000627:therapeutic use*; D000897:Anti-Ulcer Agents / Q000627:therapeutic use*; D001729:Bismuth / Q000627:therapeutic use; D016009:Chi-Square Distribution; D002927:Cimetidine / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D018530:Gastric Stump; D006801:Humans; D008297:Male; D008875:Middle Aged; D016595:Misoprostol / Q000627:therapeutic use; D009853:Omeprazole / Q000627:therapeutic use; D018709:Statistics, Nonparametric; D013276:Stomach Ulcer / Q000188:drug therapy*; D013392:Sucralfate / Q000627:therapeutic use; D016896:Treatment Outcome
D000863:Antacids; D000897:Anti-Ulcer Agents; D016595:Misoprostol; D013392:Sucralfate; D002927:Cimetidine; D009853:Omeprazole; D001729:Bismuth