Management of peptic ulcer with glycopyrrolate

Summary

1. The effects of glycopyrrolate, an anticholinergic agent, were studied in 39 ambulatory private patients with uncomplicated peptic ulceration.

2. The majority of patients tolerated dosages of 4–8 mg. a day. The necessity for individualization in relation to maximum toleration was obvious.

3. Side effects (dry mouth, mydriasis, xerostomia, delayed bladder emptying) appeared in various combinations in 21 patients, but were eliminated or minimized by adjustment of dosage.

4. All patients became asymptomatic on glycopyrrolate and the ulcer healed in 31 of the 39 patients. Two ulcers were found to be active, but smaller, when rechecked. Three patients presented duodenitis alone after therapy and 3 failed to report for follow-up.

5. An excellent reduction of gastric acidity was found in 12 of 15 patients studied experimentally. A diminished acid volume was noted in all 15 patients.

6. Glycopyrrolate exerts minimal or no effect on gastrointestinal motility following oral administration. Of 36 patients so studied, no discernible motor effect was found in 21 patients and minimal inhibition was observed in 14. In only one patient was a profound antimotility effect noted.

7. The excellent acid inhibition, coupled with minimal motor suppression combine to make glycopyrrolate a useful anticholinergic agent.