Prevention by bismuth subsalicylate of gastric mucosal lesions in response to noxious stimuli in rats

Goldenberg, Marvin M.; Honkomp, Leroy J.; Castellion, Alan W.

doi:10.1016/s0031-6989(78)80058-7

Cited by 9 publications

(2 citation statements)

References 5 publications

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“…Thus, GG311 protects gastric mucosa from indomethacin induced injury by strengthening pre-epithelial defence mechanisms in addition to inhibiting acid secretion. As gastroprotective properties of bismuth compounds may also result from inhibition of pepsin activity, binding of bile acids and epidermal growth factor, and induction of PG synthesis, and because bismuth compounds also protect the gastric mucosa from other noxious stimuli such as ethanol and cold restraint stress,2 23 it is possible that other mechanisms may also be involved in the gastroprotective effect of GG3 11. …”

Section: Discussionmentioning

confidence: 99%

Gastroprotective effect of ranitidine bismuth citrate is associated with increased mucus bismuth concentration in rats.

Tanaka

Guth

Paulsen

et al. 1996

Gut

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Section: Discussionmentioning

confidence: 99%

Gastroprotective effect of ranitidine bismuth citrate is associated with increased mucus bismuth concentration in rats.

Tanaka

Guth

Paulsen

et al. 1996

Gut

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“…In the USA, over‐the‐counter bismuth‐containing products are indicated for the treatment of overindulgence, and are recognized to sooth or relieve symptoms of heartburn, upset stomach and nausea. Although the mechanism of action of bismuth is not fully understood, it may function via topical protective effects on the gastric mucosa 33 –35 . Bismuth compounds can stain the tongue and darken stools, and neurotoxicity is a documented concern with long‐term use of high doses of some bismuth‐salts 36 –38 …”

Section: Introductionmentioning

confidence: 99%

Review article: alginate‐raft formulations in the treatment of heartburn and acid reflux

Mandel

Daggy

Brodie

et al. 2000

Aliment Pharmacol Ther

207

126

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Alginate-based raft-forming formulations have been marketed word-wide for over 30 years under various brand names, including Gaviscon. They are used for the symptomatic treatment of heartburn and oesophagitis, and appear to act by a unique mechanism which differs from that of traditional antacids. In the presence of gastric acid, alginates precipitate, forming a gel. Alginate-based raft-forming formulations usually contain sodium or potassium bicarbonate; in the presence of gastric acid, the bicarbonate is converted to carbon dioxide which becomes entrapped within the gel precipitate, converting it into a foam which floats on the surface of the gastric contents, much like a raft on water. Both in vitro and in vivo studies have demonstrated that alginate-based rafts can entrap carbon dioxide, as well as antacid components contained in some formulations, thus providing a relatively pH-neutral barrier. Several studies have demonstrated that the alginate raft can preferentially move into the oesophagus in place, or ahead, of acidic gastric contents during episodes of gastro-oesophageal reflux; some studies further suggest that the raft can act as a physical barrier to reduce reflux episodes. Although some alginate-based formulations also contain antacid components which can provide significant acid neutralization capacity, the efficacy of these formulations to reduce heartburn symptoms does not appear to be totally dependent on the neutralization of bulk gastric contents. The strength of the alginate raft is dependant on several factors, including the amount of carbon dioxide generated and entrapped in the raft, the molecular properties of the alginate, and the presence of aluminium or calcium in the antacid components of the formulation. Raft formation occurs rapidly, often within a few seconds of dosing; hence alginate-containing antacids are comparable to traditional antacids for speed of onset of relief. Since the raft can be retained in the stomach for several hours, alginate-based raft-forming formulations can additionally provide longer-lasting relief than that of traditional antacids. Indeed, clinical studies have shown Gaviscon is superior to placebo, and equal to or significantly better than traditional antacids for relieving heartburn symptoms. Alginate-based, raft-forming formulations have been used to treat reflux symptoms in infants and children, and in the management of heartburn and reflux during pregnancy. While Gaviscon is effective when used alone, it is compatible with, and does not interfere with the activity of antisecretory agents such as cimetidine. Even with the introduction of new antisecretory and promotility agents, alginate-rafting formulations will continue to have a role in the treatment of heartburn and reflux symptoms. Their unique non-systemic mechanism of action provides rapid and long-duration relief of heartburn and acid reflux symptoms.

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Bismuth therapy in gastrointestinal diseases

1990

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Prevention by bismuth subsalicylate of gastric mucosal lesions in response to noxious stimuli in rats

Cited by 9 publications

References 5 publications

Gastroprotective effect of ranitidine bismuth citrate is associated with increased mucus bismuth concentration in rats.

Gastroprotective effect of ranitidine bismuth citrate is associated with increased mucus bismuth concentration in rats.

Review article: alginate‐raft formulations in the treatment of heartburn and acid reflux

Bismuth therapy in gastrointestinal diseases

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