PROTECTION OF THE GASTRODUODENAL MUCOSA FROM THE EFFECTS OF DICLOFENAC SODIUM - ROLE OF HIGHLY SELECTIVE VAGOTOMY AND MISOPROSTOL

The aim of this study was to determine the effectiveness of highly sel ective vagotomy (HSV) or misoprostol, a prostaglandin E(1) (PGE(1)) an alog, for protecting the gastroduodenal mucosa (GDM) from the effects of diclofenac sodium (DS). Fifty mongrel dogs were randomly allocated to five groups. HSV alone was performed in group ii dogs (controls) to standardize the operation. DS was given intramuscularly for 12 consec utive days to the group II dogs, whereas in the group III dogs HSV was performed, followed a month later by DS administration, as in group I I. DS was given in combination with misoprostol for 12 days to the gro up IV dogs. HSV was performed on the group V dogs, and a month later D S and misoprostol were given, as in group IV. After sacrificing the an imals the GDM was examined for macroscopic and histologic lesions. Sta tistical analysis was made by Fisher's exact test. HSV alone did not p rotect the gastric or duodenal mucosa from the effects of DS (p = 0.47 4 and p = 0.62, respectively). Misoprostol alone also did hbt offer si gnificant protection to the gastric or the duodenal mucosa (p = 0.08 a nd p = 0.65, respectively). The combination of HSV plus misoprostol pr otected the gastric mucosa (group V, p = 0.007) but not the duodenal m ucosa (group V, p = 0.08). Hence HSV or misoprostol alone offers no pr otection to the GDM from the effects of DS. The combination of HSV and misoprostol offers significant protection only to gastric mucosa. Enh ancement of the mucosal defense mechanisms combined with strong reduct ion of gastric acidity may offer adequate protection to gastric mucose from the effects of nonsteroidal antiinflammatory drugs.