EFFECTS OF MISOPROSTOL ON HEALING AND PREVENTION OF BIOPSY-INDUCED GASTRODUODENAL LESIONS OCCURRING DURING THE ADMINISTRATION OF DICLOFENACTO VOLUNTEERS

Aim: To determine whether misoprostol promotes the healing of non-ster oidal anti-inflammatory drug-induced gastroduodenal lesions in a human experimental model. Methods: Mucosal damage and healing of mucosal bi opsy sites were assessed endoscopically in 10 healthy, Helicobacter py lori-negative volunteers with a normal initial endoscopy: they were en rolled in a double-blind, double-dummy, placebo-controlled cross-over study. They received 2-week courses of misoprostol (200 mu g b.d.) or placebo: a water-soluble non-steroidal anti-inflammatory drug diclofen ac 50 mg t.d.s., was given during the second week of each dosage regim en after three endoscopic biopsies had been taken from each of the duo denum, antrum and corpus. Results: The number of unhealed biopsy sites was not different after misoprostol or placebo, although the number o f healed biopsy sites was greater in the corpus and duodenum than in t he antrum. Misoprostol did not prevent the appearance of diclofenac-in duced erosions and petechiae. Epigastric discomfort was related to the intake of diclofenac and was reduced by misoprostol. Bloating and fla tulence occurred more frequently with misoprostol alone and with misop rostol plus diclofenac, than with placebo alone or placebo plus diclof enac. Conclusion: Misoprostol does not prevent new mucosal lesions ind uced by diclofenac in healthy volunteers and it does not accelerate th e healing of the biopsy sites. Misoprostol decreases the frequency of diclofenac-induced epigastric discomfort, but it increases gas bloatin g and flatulence.