Abstract
The aim of this study was to determine the effect of colloidal bismuth subcitrate (De Nol) on symptoms and gastric histology in patients with non-ulcer dyspepsia. In a single centre trial, patients with food related upper abdominal pain not caused by ulcer disease were randomised to receive one tablet of colloidal bismuth subcitrate or matching placebo four times daily for eight weeks. Seventy three patients were entered and 51 completed the trial: 28 patients in the colloidal bismuth subcitrate group and 23 in the placebo group. Overall there was no difference between the two groups in terms of symptom relief. Among patients with histological gastritis (n = 23), however, those who took colloidal bismuth subcitrate used fewer antacid tablets (for three of four fortnightly periods) and were more likely to become asymptomatic (eight of 11 v three of 12, p less than 0.05); their gastritis was more likely to resolve (five of 10 v 0 of 12, p less than 0.025) and their gastric biopsies more likely to become negative for Helicobacter like organisms (eight of nine v 0 of 12, p less than 0.001) when compared with patients taking placebo. In contrast, patients who did not have gastritis in their index biopsies (n = 28) fared similarly whether they received colloidal bismuth subcitrate or placebo. Our results indicate that the administration of colloidal bismuth subcitrate benefited non-ulcer dyspepsia patients with gastritis but had no effect on those without.
Full text
PDF![476](https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e235/1378428/d1b2a85302d7/gut00598-0132.png)
![477](https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e235/1378428/c3f072baa9f6/gut00598-0133.png)
![478](https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e235/1378428/86ee4f731174/gut00598-0134.png)
![479](https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e235/1378428/03a95ef95a8d/gut00598-0135.png)
![480](https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e235/1378428/396a0d5d4af3/gut00598-0136.png)
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Bonnevie O. Dyspepsia: Future research--methodological aspects. Scand J Gastroenterol Suppl. 1987;128:114–116. doi: 10.3109/00365528709090978. [DOI] [PubMed] [Google Scholar]
- Dal Monte P. R., D'Imperio N., Accardo P., Daniotti S. Pirenzepine in non-ulcer dyspepsia. A double-blind, placebo controlled trial. Scand J Gastroenterol Suppl. 1982;72:247–250. [PubMed] [Google Scholar]
- Hradsky M., Wikander M. Effect of pirenzepine in the treatment of non-ulcer dyspepsia. A double-blind study. Scand J Gastroenterol Suppl. 1982;72:251–254. [PubMed] [Google Scholar]
- Johannessen T., Fjøsne U., Kleveland P. M., Halvorsen T., Kristensen P., Løge I., Hafstad P. E., Sandbakken P., Petersen H. Cimetidine responders in non-ulcer dyspepsia. Scand J Gastroenterol. 1988 Apr;23(3):327–336. doi: 10.3109/00365528809093874. [DOI] [PubMed] [Google Scholar]
- Kleveland P. M., Larsen S., Sandvik L., Kristensen P., Johannessen T., Hafstad P. E., Sandbakken P., Løge I., Fjøsne U., Petersen H. The effect of cimetidine in non-ulcer dyspepsia. Experience with a multi-cross-over model. Scand J Gastroenterol. 1985 Jan;20(1):19–24. doi: 10.3109/00365528509089627. [DOI] [PubMed] [Google Scholar]
- Manning A. P., Thompson W. G., Heaton K. W., Morris A. F. Towards positive diagnosis of the irritable bowel. Br Med J. 1978 Sep 2;2(6138):653–654. doi: 10.1136/bmj.2.6138.653. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Marshall B. J., Armstrong J. A., Francis G. J., Nokes N. T., Wee S. H. Antibacterial action of bismuth in relation to Campylobacter pyloridis colonization and gastritis. Digestion. 1987;37 (Suppl 2):16–30. doi: 10.1159/000199555. [DOI] [PubMed] [Google Scholar]
- Marshall B. J., Warren J. R. Unidentified curved bacilli in the stomach of patients with gastritis and peptic ulceration. Lancet. 1984 Jun 16;1(8390):1311–1315. doi: 10.1016/s0140-6736(84)91816-6. [DOI] [PubMed] [Google Scholar]
- McNulty C. A., Gearty J. C., Crump B., Davis M., Donovan I. A., Melikian V., Lister D. M., Wise R. Campylobacter pyloridis and associated gastritis: investigator blind, placebo controlled trial of bismuth salicylate and erythromycin ethylsuccinate. Br Med J (Clin Res Ed) 1986 Sep 13;293(6548):645–649. doi: 10.1136/bmj.293.6548.645. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Nesland A. A., Berstad A. Effect of cimetidine in patients with non-ulcer dyspepsia and erosive prepyloric changes. Scand J Gastroenterol. 1985 Jun;20(5):629–635. doi: 10.3109/00365528509089708. [DOI] [PubMed] [Google Scholar]
- Nyrén O., Adami H. O., Bates S., Bergström R., Gustavsson S., Löf L., Nyberg A. Absence of therapeutic benefit from antacids or cimetidine in non-ulcer dyspepsia. N Engl J Med. 1986 Feb 6;314(6):339–343. doi: 10.1056/NEJM198602063140603. [DOI] [PubMed] [Google Scholar]
- Rathbone B. J., Wyatt J. I., Worsley B. W., Shires S. E., Trejdosiewicz L. K., Heatley R. V., Losowsky M. S. Systemic and local antibody responses to gastric Campylobacter pyloridis in non-ulcer dyspepsia. Gut. 1986 Jun;27(6):642–647. doi: 10.1136/gut.27.6.642. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Rauws E. A., Langenberg W., Houthoff H. J., Zanen H. C., Tytgat G. N. Campylobacter pyloridis-associated chronic active antral gastritis. A prospective study of its prevalence and the effects of antibacterial and antiulcer treatment. Gastroenterology. 1988 Jan;94(1):33–40. [PubMed] [Google Scholar]
- Rokkas T., Pursey C., Uzoechina E., Dorrington L., Simmons N. A., Filipe M. I., Sladen G. E. Campylobacter pylori and non-ulcer dyspepsia. Am J Gastroenterol. 1987 Nov;82(11):1149–1152. [PubMed] [Google Scholar]
- Rokkas T., Pursey C., Uzoechina E., Dorrington L., Simmons N. A., Filipe M. I., Sladen G. E. Non-ulcer dyspepsia and short term De-Nol therapy: a placebo controlled trial with particular reference to the role of Campylobacter pylori. Gut. 1988 Oct;29(10):1386–1391. doi: 10.1136/gut.29.10.1386. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Saunders J. H., Oliver R. J., Higson D. L. Dyspepsia: incidence of a non-ulcer disease in a controlled trial of ranitidine in general practice. Br Med J (Clin Res Ed) 1986 Mar 8;292(6521):665–668. doi: 10.1136/bmj.292.6521.665. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Talley N. J., McNeil D., Hayden A., Piper D. W. Randomized, double-blind, placebo-controlled crossover trial of cimetidine and pirenzepine in nonulcer dyspepsia. Gastroenterology. 1986 Jul;91(1):149–156. doi: 10.1016/0016-5085(86)90451-8. [DOI] [PubMed] [Google Scholar]