Abstract
A high incidence of gastric ulceration is reported in patients with rheumatoid arthritis and in addicts taking large doses of aspirin. In rheumatoid arthritis a serum salicylate level of 15 mg% is considered to be therapeutic. We studied gastric mucosal permeability to ions in 9 healthy subjects given 3 g aspirin intravenously over 2 hours (mean serum salicylate, 17 mg%). Atropine was injected intravenously to reduce acid secretion which masks H+ loss. H+ and Na+ fluxes during aspirin infusion were not significantly different from those during intravenous saline infusion. Thus, high blood levels of salicylates did not impair the gastric mucosal barrier. Intragastric salicylic acid following intravenous aspirin infusion increased gastric mucosal permeability to H+ and Na+ ions. Under the conditions of these studies the effect was more marked in males. Gastric absorption of salicylic acid was similar in males and females, and the amount absorbed was unaffected by the presence of high blood levels of salicylates. Absorption of salicylic acid was significantly greater in the first period of salicylic acid instillation (mean, 28%) than in the second (mean, 21%) and third (mean, 16%) periods. Percentage absorption of undissociated salicylic acid was at least three times greater than that of H+ ions.
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References
Davenport HW: Gastric mucosal injury by fatty and acetylsalicylic acids. Gastroenterology 46:245–253, 1964
Ivey KJ, Morrison S, Gray C: Effect of salicylates on the gastric mucosal barrier in man. J Appl Physiol 33:81–85, 1972
Overholt BF, Pollard HM: Acetylsalicylic and ionic fluxes across the gastric mucosa of man. Gastroenterology 54:538–542, 1968
Geall MG, Phillips SE, Summerskill WH: The profile of gastric potential difference in man: Effects of aspirin, alcohol, bile and endogenous acid. Gastroenterology 58:437–443, 1970
Smith BM, Skillman JJ, Edwards BG, et al: Permeability of the human gastric mucosa: Alteration by acetylsalicylic acid and ethanol. N Engl J Med 285:716–721, 1971
Gillies MA, Skyring AP: Gastric and duodenal ulcer: The association between aspirin ingestion, smoking and family history of ulcer. Med J Aust 1:280–285, 1969
Chapman BL, Duggan JM: Aspirin and uncomplicated peptic ulcer. Gut 10:443–450, 1969
Douglas RA, Johnson ED: Aspirin and chronic gastric ulcer. Med J Aust 2:893–897, 1961
Kern F, Clark GM, Lukens JG: Peptic ulceration occurring during therapy for rheumatoid arthritis. Gastroenterology 33:25–33, 1957
Emmanuel JH, Montgomery RD: Gastric ulcer and the anti-arthritic drugs. Postgrad Med J 47:227–232, 1971
Ivey KJ, Clifton JA: Reproducibility and effect of atropine. J Lab Clin Med 78:753–764, 1971
Ivey KJ, Den Besten L, Clifton JA: Effect of bile salts and atropine on ionic movement across the human gastric mucosa. Gut 12:257–261, 1971
Garrett ER: Prediction of stability in pharmaceutical preparations: IV. The interdependence of solubility and rate in saturated solution of acylsalicylates. J Am Pharm Assoc (Sci) 46:584–588, 1957
Ivey KJ, Schedl HP: Comparison of polyethylene glycol, phenol red and chromium chloride as non-absorbable indicators in the human stomach. Gastroenterology 59:234–239, 1970
Trinder P: Rapid determination of salicylates in biological fluids. Biochem J 57:301–303, 1954
Hunt JN: The secretory pattern of the stomach of man. J Physiol (London) 113:169–184, 1951
Davenport HW: Gastric mucosal haemorrhage in dogs: Effect of acid, aspirin and alcohol. Gastroenterology 56:439–449, 1969
Ivey KJ, Den Besten L, Bell S: Absorption of bile salts from the human stomach. J Appl Physiol 29:806–808, 1970
Lynch A, Shaw H, Milton GW: Effect of aspirin on gastric secretion. Gut 5:230–236, 1964
Brodie DA, Chase BJ: Role of gastric acid in aspirin-induced gastric irritation in the rat. Gastroenterology 53:604–610, 1967
Overholt BF, Brodie DA, Chase BJ: Effect of the vagus nerve and salicylate administration on the permeability characteristics of the rat gastric mucosal barrier. Gastroenterology 56:651–658, 1969
Grossman MI, Matsumoto KK, Lichter RF: Faecal blood loss produced by oral and intravenous administration of various salicylates. Gastroenterology 40:383–388, 1961
Cooke AR, Goulston K: Failure of intravenous aspirin to increase gastrointestinal blood loss. Br Med J 3:330–332, 1969
Winkelman EI, Summerskill WJH: Gastric secretion in relation to gastrointestinal bleeding from salicylate compounds. Gastroenterology 40:56–63, 1961
Jones FA: Hematemesis and melena. Br Med J 2:479–483, 1947
Sandweiss DJ, Saltzstein HC, Farbman AA: The relation of sex hormones to peptic ulcer. Am J Dig Dis 6:6–10, 1939
Clark DH, Tankel HI: Gastric acid and plasma histaminase during pregnancy. Lancet 2:886–888, 1954
Winkelstein A: Observations on ulcerations adjacent to experimental gastric pouches in dogs. Am J Dig Dis 3:229–233, 1936
Truelove SC: Stilboestrol, phenobarbitone, and diet in chronic duodenal ulcer: A factorial therapeutic trial. Br Med J 3:559–566, 1960
Hollander F: Gastric secretion of electrolytes. Fed Proc 11:706–714, 1952
Frenning B: The disappearance of acetyl salicylic acid (ASA) in aqueous solution from the cat stomach and its influence on the transmucosal ion transport in the innervated nonsecreting stomach. Acta Physiol Scand 83:235–246, 1971
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This study was supported by research grants from the N. S. W. State Cancer Council and the National Health and Medical Research Council.
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Ivey, K.J., Morrison, S. & Gray, C. Effect of intravenous salicylates on the gastric mucosal barrier in man. Digest Dis Sci 17, 1055–1064 (1972). https://doi.org/10.1007/BF02232307
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DOI: https://doi.org/10.1007/BF02232307