CYTOPROTECTIVE EFFECTS OF COLLOIDAL BISMUTH SUBCITRATE IN PATIENTS WITH ULCER DISEASE

Helicobacter pylori is capable of altering the structure of the mucus gel adhering to the surface of the gastric antral wall, Thirty patient s (22 men and 8 women) with endoscopic evidence of active duodenal ulc er and histologically confirmed H pylori antral gastritis participated in this prospective study. The study objective was to evaluate the ef fects of 6 weeks of treatment with colloidal bismuth subcitrate (two 1 20-mg tablets twice daily) on peptic secretion and the gastric mucosal barrier. Samples of gastric juice were collected during endoscopy to measure pepsin levels, Also during endoscopy, four biopsies were taken (two antral and two from the body/fundus) for histologic examination, H pylori detection, and the quantification of pepsinogen group A (PGA ), gastrin, and pepsin in the tissues, AH of the above parameters were repeated with endoscopy after 6 weeks of treatment. Ulcer healing was obtained in 26 (87%) of 30 patients after treatment. H pylori infecti on was cleared in 15 (50%) patients. No significant changes were detec ted in concentrations of pepsin in the gastric juice or concentrations of PGA, gastrin, or pepsin in the tissues. Mucus depletion was visibl y lower after treatment, suggesting that colloidal bismuth subcitrate may alter the bacterial microenvironment, regenerating the quantity of mucus.