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Healing of Duodenal Ulcer with an Antacid Regimen

List of authors.
  • Walter L. Peterson, M.D.,
  • Richard A. L. Sturdevant, M.D.,
  • Harold D. Frankl, M.D.,
  • Charles T. Richardson, M.D.,
  • Jon I. Isenberg, M.D.,
  • Janet D. Elashoff, Ph.D.,
  • James Q. Sones, M.D.,
  • Robert A. Gross, M.D.,
  • Richard W. McCallum, M.B., B.S.,
  • and John S. Fordtran, M.D.

Abstract

To determine whether a large-dose antacid regimen is effective in promoting healing of duodenal ulcer, 74 patients with endoscopically proved duodenal ulcer completed a 28-day double-blind clinical trial comparing such a regimen with an inert placebo. The ulcer healed completely in 28 of the 36 antacid-treated as compared to 17 of the 38 placebo-treated patients (P<0.005). The antacid regimen was not more effective than placebo in relieving ulcer symptoms. Presence or absence of symptoms during the fourth treatment week was a poor predictor of presence or absence of an ulcer crater. Ulcers of placebo-treated patients who smoked cigarettes were less likely to heal than those of nonsmokers (P = 0.03). Except for mild diarrhea, no side effects of the antacid regimen were observed. We conclude that a large-dose antacid regimen hastens the healing of duodenal ulcer. (N Engl J Med 297:341–345, 1977)

Funding and Disclosures

Participating hospitals were Parkland Memorial Hospital, Dallas, Veterans Administration Hospital, Dallas, Wadsworth Veterans Administration Hospital, Los Angeles, and Kaiser Sunset Hospital, Los Angeles.

Supported by a grant (AM 17328) from the National Institute of Arthritis, Metabolism, and Digestive Diseases to the Center for Ulcer Research and Education, Veterans Administration Hospital, Dallas, TX, and the Veterans Administration Hospital Center, Los Angeles, CA (some patients were hospitalized overnight in General Clinical Research Center with the support of a grant [RR 00633] and computing assistance was obtained from the Health Sciences Computing Facility, UCLA, with the support of a special research resources grant from the National Institutes of Health) (Dr. Sones is the recipient of an Upjohn Graduate Fellowship in Clinical Pharmacology).

We are indebted to John H. Walsh, M.D., Los Angeles, CA, who performed the serum gastrin determinations, to I. Michael Samloff, M.D., Torrance, CA, who performed the serum pepsinogen determinations, and to John F. Morrissey, M.D., Madison, WI, for endoscopic advice.

Author Affiliations

From the Center for Ulcer Research and Education, Los Angeles, CA, and Dallas, TX, the Department of Internal Medicine, University of Texas Health Science Center at Dallas, the Department of Medicine, UCLA Center for the Health Sciences, and the Department of Medicine, Kaiser–Permanente Medical Center, Los Angeles (address reprint requests to Dr. Peterson at the Gastroenterology Section [111B], Veterans Administration Hospital, 4500 S. Lancaster Rd., Dallas, TX 75216).

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