Sucralfate protects blood clots from peptic digestion by gastric juice in vitro.
OBJECTIVE
To test in vitro the ability of sucralfate to protect a blood clot from peptic digestion by gastric juice.


METHODS
Blood clots adhering to the bottom of plastic tubes were exposed to native acidic gastric juice or gastric juice to which Al-Mg antacids, sucralfate or alkali had been added. The tubes were tilted regularly at room temperature and clot digestion monitored by measuring the diameters of the clots. After 15 h, the liquids, but not the adherent clots, were poured out and the tubes refilled with native acidic gastric juice. Further clot digestion was measured, as before.


RESULTS
Native gastric juice digested the clots completely during approximately 7 h, while in neutralized gastric juice or in gastric juice containing antacids or sucralfate no digestion was seen. In the second experiment, native gastric juice completely digested all remaining clots, except those previously exposed to sucralfate. A dose-response study indicated that gastric juice containing 3% or more of sucralfate had this long-lasting, clot-protective effect.


CONCLUSIONS
In vitro, sucralfate adheres to and protects blood clots from digestion by gastric juice pepsin. This unique effect of sucralfate may be of clinical relevance in the treatment of bleeding peptic ulcers.
Nysaeter
Gunnar
G
Section for Gastroenterology, Department of Medicine and Institute of Medicine, Haukeland University Hospital, Bergen, Norway. gunnar.nyseter@helse-bergen.no
Berstad
Arnold
A
D000897:Anti-Ulcer Agents / Q000494:pharmacology*; D005342:Fibrinolysis / Q000187:drug effects*; D005750:Gastric Juice / Q000378:metabolism*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D066298:In Vitro Techniques; D013392:Sucralfate / Q000494:pharmacology*
D000897:Anti-Ulcer Agents; D013392:Sucralfate