Sucralfate

Article Abstract:

Sucralfate is a medication that has proved effective in the treatment of stomach ulcers and duodenal ulcers. While the events leading to the development of ulcers remain uncertain, there is no doubt that stomach acid is responsible for most of the damage. It is not surprising, therefore, that today's effective treatments reduce the effects of stomach acid. Chemically, sucralfate is a complex salt of aluminum hydroxide and sucrose octasulfate. Sucrose, which is common cane sugar, is a disaccharide, that is, it is composed of two simple sugars. This disaccharide is modified by the addition of eight sulfate groups which, under some conditions, may become ionized. This property permits the association of the sucrose octasulfate with the aluminum hydroxide to form the chemical salt. The resulting sucralfate is very poorly soluble in water. Under the acidic conditions in the stomach, sucralfate becomes electrically charged and binds strongly to both normal tissue and ulcer tissue. This binding results in a protective gel, which stands between the ulcer and the erosive stomach acid. This protective effect is not the only beneficial effect that sucralfate may have. Unlike some other antiulcer drugs, sucralfate has only slight effects on the secretion of stomach acid. However, sucralfate binds the powerful digestive enzyme pepsin, thereby reducing the amount of pepsin that is free to harm the ulcer tissue. Sucralfate also seems to augment the stomach's own mucus. Under normal conditions, the lining of the stomach is insulated from the digestive acids and enzymes by protective mucus; sucralfate increases the production of this mucus. In addition, sucralfate increases the viscosity of the mucus and alters its properties in other ways that increase its protective value. The full details of the physiological effects of sucralfate are not completely understood, but there is evidence that sucralfate improves blood flow to ulcer tissue, a process critical for healing. Furthermore, there are indications that sucralfate may stimulate the production of hormones that promote tissue healing. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Physiological aspects, Peptic ulcer, Sucralfate

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Effect of ranitidine and amoxicillin plus metronidazole on the eradication of Helicobacter pylori and the recurrence of duodenal ulcer

Article Abstract:

Eradicating the bacterium Helicobacter pylori with antibiotics appears to reduce the recurrence of duodenal ulcer. Of 102 patients who had had at least two recurrent episodes of duodenal ulcer and were infected with Helicobacter pylori, 51 were treated with the antibiotics amoxicillin and metronidazole and 51 took placebo. All were treated with ranitidine, which inhibits the secretion of acid in the stomach. The rate of ulcer healing at six weeks was significantly higher among patients who had taken antibiotics than among those who had taken placebo. The bacterium was eradicated in 89% of patients who had taken antibiotics compared with only 2% who had taken placebo. At six weeks, duodenal ulcer recurred in 2% of the patients who were negative for the bacterium, compared to 85% who were still positive. In the year following treatment, 8% who had taken antibiotics had a recurrence of duodenal ulcer compared with 86% who had taken placebo. These findings indicate that Helicobacter pylori infection contributes to recurrent duodenal ulcer.

Prevention, Helicobacter infections, Amoxicillin

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A randomized study of maintenance therapy with ranitidine to prevent the recurrence of duodenal ulcer

Article Abstract:

Duodenal ulcers are lesions caused by the acidic gastric juices eroding the intestinal wall. Treatment with ulcer-healing drugs usually restores the integrity of the intestines within four to eight weeks. However, for many, ulcers return within the year. Two management approaches were evaluated for effective long-term control: continual maintenance therapy and treatment only when the ulcers recurred. One group was given a maintenance dose of ranitidine, a common ulcer treatment drug, while the other was given a placebo. The placebo group had a 63 percent relapse rate, compared with a 37 percent rate in the ranitidine users. Recurrences in the patients receiving a placebo were subsequently treated with ranitidine, and most patients experienced additional relapse. Regular therapy also reduced the frequency of recurrences. Patients who use alcohol, smoke, have ulcer disease history and previous intestinal scarring had more ulcer recurrences and benefited the most from maintenance therapy.

Ranitidine

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