[Morphology of the gastric mucosa in patients with duodenal ulcer treated with bismuth-containing drugs].

The aim of this study was the effect of antacids containing inorganic bismuth compounds on the morphology of the gastric mucosa and healing of the duodenal ulcer (DU) in patients with exacerbation of the ulcer disease. 169 patients were treated for four weeks with low-dose antacids (two drugs containing bismuth subnitrate--Gastrin and Wikalina, with buffering capacity below 200 mmol HCl per day) and for comparison with ranitidine, colloidal bismuth subcitrate and placebo. We evaluated the effect of these drugs on the morphology of gastric mucosa using endoscopic, histologic and morphometric methods, as well as healing of DU, ulcer symptoms and drug tolerance. Antacids and colloidal bismuth subcitrate decreased both the chronic active gastritis of praepyloric region and frequency of Helicobacter infection, however without the full eradication. Antacids, ranitidine and colloidal bismuth subcitrate did not affect the height of surface epithelium, thickness of foveolar and glandular mucosa as well as the number and size of parietal cells, thus they were without any trophic effects on the gastric mucosa. All mentioned drugs healed DU in 68-73% of patients and significantly better than placebo (46%). These drugs were well tolerated by patients, however antacids caused slight increase in pH of urine and transient hipermagnesemia. Because the etiopathogenese of ulcer disease is still unclear, its therapy is unsuccessful in many cases. We should stress that the treatment with antacids in some cases can be a good and safe alternative therapy in spite of many other currently used medications.