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

A double-blind study with cimetidine and follow-up

Digestive Diseases and Sciences volume 27, pages 976–980 (1982)Cite this article

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.

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Author information

Affiliations

  1. Division of Gastroenterology, Veterans Administration Medical Center, 5901 East Seventh Street, 90822, Long Beach, California

    Joseph C. O'Laughlin, Gerald K. Silvoso &  Kevin J. Ivey

  2. University of California, Irvine, California

    Joseph C. O'Laughlin, Gerald K. Silvoso &  Kevin J. Ivey

  3. University of Missouri, Columbia, Missouri

    Joseph C. O'Laughlin, Gerald K. Silvoso &  Kevin J. Ivey

Authors
  1. Joseph C. O'Laughlin
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  2. Gerald K. Silvoso
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  3. Kevin J. Ivey
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O'Laughlin, J.C., Silvoso, G.K. & Ivey, K.J. Resistance to medical therapy of gastric ulcers in rheumatic disease patients taking aspirin. Digest Dis Sci 27, 976–980 (1982). https://doi.org/10.1007/BF01391742

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  • DOI: https://doi.org/10.1007/BF01391742

Keywords

  • Placebo
  • Aspirin
  • Cimetidine
  • Salicylate
  • Gastric Ulcer