Document Detail

The relationship between the content of aggressive and protective components in gastric juice and endoscopic findings after naproxen sodium and acetaminophen administration.
MedLine Citation:
PMID:  8607507     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: To evaluate the diagnostic value of residual gastric juice, we assessed various secretory components before and after placebo, acetaminophen, or naproxen sodium administration. METHODS: In a double-blind, randomized, cross-over study in 30 asymptomatic volunteers, mucin, hydrophobicity, protein, pepsin, and pH were measured in residual gastric juice before and after placebo, naproxen sodium (660 mg/d), or acetaminophen (4000 mg/d) administration. Mucus layer thickness in biopsy specimens was assessed, and mucosal damage was endoscopically evaluated. RESULTS: All parameters were unchanged after 7 days of placebo. Naproxen caused a 46% (p = 0.008) increase in the rate of luminal mucin release, an 18% increase (p = 0.510) in protein release, and a 61% decrease (p = 0.001) in hydrophobicity. Antral and duodenal mucus gel thickness were compromised, and hemorrhagic and erosive endoscopic changes were noted. Acetaminophen resulted only in a significant decline of pepsin. In subjects without endoscopic damage after naproxen, a nonsignificant decrease in hydrophobicity was noted. However, in subjects with endoscopic changes, a 55% decrease (p = 0.002) in hydrophobicity and a 42% increase (p = 0.024) in the rate of luminal mucin release were demonstrated. The initial mucin of subjects who developed endoscopic mucosal changes after naproxen was 53% higher than in subjects without damage. Subjects with endoscopic changes also exhibited a 48% lower initial hydrophobicity and a 43% lower pepsin than subjects without endoscopic changes. CONCLUSIONS: Gastric mucosal damage after naproxen sodium results in profound changes within the gastric mucosal barrier, and analysis of residual gastric juice components adequately reflects these changes. In contrast, acetaminophen results in only minimal gastric juice changes. Analysis of residual gastric juice may be useful in monitoring the extent of mucosal damage and identifying patients likely to develop mucosal damage.
M Marcinkiewicz; D A Peura; J Sarosiek
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The American journal of gastroenterology     Volume:  91     ISSN:  0002-9270     ISO Abbreviation:  Am. J. Gastroenterol.     Publication Date:  1996 Feb 
Date Detail:
Created Date:  1996-05-17     Completed Date:  1996-05-17     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  0421030     Medline TA:  Am J Gastroenterol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  360-5     Citation Subset:  IM    
University of Virginia Health Sciences Center, Charlottesville, USA.
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MeSH Terms
Acetaminophen / adverse effects*
Analgesics, Non-Narcotic / adverse effects*
Anti-Inflammatory Agents, Non-Steroidal / adverse effects*
Centrifugation, Density Gradient
Cross-Over Studies
Double-Blind Method
Gastric Juice / chemistry*
Gastric Mucins / analysis
Gastric Mucosa / drug effects*,  pathology
Middle Aged
Mucus / drug effects
Naproxen / adverse effects*
Pepsin A / analysis
Proteins / analysis
Reg. No./Substance:
0/Analgesics, Non-Narcotic; 0/Anti-Inflammatory Agents, Non-Steroidal; 0/Gastric Mucins; 0/Placebos; 0/Proteins; 103-90-2/Acetaminophen; 22204-53-1/Naproxen; EC A

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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