Treatment of Duodenal Ulcer with Low-Dose Antacids

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Abstract
The aim of the present investigation was to compare the efficacy of a low-dose antacid (Maalox 70®, 280mmol/day) with that of the H2-receptor antagonist cimetidine (Tagamet®, 200 mg three times daily and 400 mg/day) after 14 and 28 days in the treatment of duodenal ulcer. The prospective multicentre study included 171 patients with endoscopically confirmed duodenal ulcers. The patients were randomly assigned to the treatment groups with antacid containing Mg and Al hydroxide (M)(4 × 70mmol/day; n = 86) or to the group receiving cimetidine (T)(1000 mg/ day; n = 85). The two treatment groups were matched for age, sex, drinking and smoking habits, and drug use. Endoscopic examinations were carried out before the start of treatment and 14 days later. If the ulcer was still present at this time, the second endoscopic examination was done after a further 14 days. Endoscopically, the ulcer had healed at 14 days in 38.8% (M) and in 34.9% (T) and at 28 days in 80.0% (M) and 74.7% (T), respectively. The healing rate did not differ significantly between the two treatment groups. Complaints, measured as percentage of days per week with upper abdominal pain, were significantly reduced in both groups. No significant differences were found between the two treatment groups with regard to pain relief or side effects. Treatment had to be abandoned in one patient receiving antacid because of diarrhoea and in one patient receiving cimetidine because of the absence of any response. In neither of the two groups was any significant influence on stool habits observed. In decreasing order of importance, the following factors proved to have prognostic relevance: size of ulcer, sex, and age; in the present study, neither with antacid nor with cimetidine was any effect of nicotine or alcohol on ulcer healing demonstrable.