Digestive Diseases and Sciences

, Volume 27, Issue 11, pp 976–980

Resistance to medical therapy of gastric ulcers in rheumatic disease patients taking aspirin

A double-blind study with cimetidine and follow-up
  • Joseph C. O'Laughlin
  • Gerald K. Silvoso
  • Kevin J. Ivey
Original Articles

DOI: 10.1007/BF01391742

Cite this article as:
O'Laughlin, J.C., Silvoso, G.K. & Ivey, K.J. Digest Dis Sci (1982) 27: 976. doi:10.1007/BF01391742

Abstract

Little is known about healing or recurrence of aspirin-induced gastric ulcers if aspirin intake is continued. A double-blind controlled study compared cimetidine plus antacids as needed (prn) with placebo plus prn antacids in healing aspirin-associated gastric ulcers during continued salicylate ingestion in 18 rheumatic disease patients over a 2-month period. Healing occurred in 44% of the placebo and 56% of the cimetidine-treated patients (P>0.05). Subjects in both groups ingested potentially therapeutic doses of antacid. Ulcer size had an effect on healing rate, irrespective of treatment. Ninety percent of gastric ulcers<0.5 cm in diameter healed in 2 months but only 25% of ulcers>0.5 cm. Six of seven patients with unhealed ulcers at 2 months eventually healed medically at intervals of 6–26 months. Of 11 patients managed medically and followed endoscopically for a mean of 15 months after healing, only one had a recurrent ulcer. In conclusion, placebo and antacid therapy were as effective as cimetidine and antacids in healing ulcers over a 2-month period. In spite of continued aspirin intake, most benign gastric ulcers <0.5 cm in diameter heal medically in two months. Aspirin-induced ulcers≥1 cm in diameter are relatively resistant to therapy but can be healed with prolonged cimetidine and antacid treatment; once healed, recurrence rate is low with prophylactic therapy even with continued aspirin intake.

Copyright information

© Digestive Disease Systems, Inc. 1982

Authors and Affiliations

  • Joseph C. O'Laughlin
    • 1
    • 2
    • 3
  • Gerald K. Silvoso
    • 1
    • 2
    • 3
  • Kevin J. Ivey
    • 1
    • 2
    • 3
  1. 1.Division of GastroenterologyVeterans Administration Medical CenterLong Beach
  2. 2.University of CaliforniaIrvine
  3. 3.University of MissouriColumbia

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