Healing of Aspirin-Associated Peptic Ulcer Disease Despite Continued Salicylate Ingestion

Invited commentary

“…In patients with rheumatic disease taking 8 tablets per day or more for 3 or more months, there was a significantly lower incidence of gastric ulcers in those taking enteric-coated tablets compared to those taking regular aspirin [3]. In subsequent studies, we have shown that aspirin-induced ulcers can be healed while aspirin therapy is continued by treatment with large doses of antacids and/or the histamine H2 blocker cimetidine [6,7]. Ulcers 1 cm in diameter or less can usually be healed within 2 months [6].…”

“…In subsequent studies, we have shown that aspirin-induced ulcers can be healed while aspirin therapy is continued by treatment with large doses of antacids and/or the histamine H2 blocker cimetidine [6,7]. Ulcers 1 cm in diameter or less can usually be healed within 2 months [6]. With ulcers greater than 1 cm in diameter many months of therapy (6 to 27) plus changing aspirin to the enteric-coated type is required [7].…”

Cimetidine does not alter ibuprofen kinetics after a single dose.

“…Cimetidine has been shown to prevent gastritis due to nonsteroidal anti-inflammatory agents and aspirin in animals (Mann & Sachdev,977). Furthermore, healing of salicylate-induced ulcers has been shown with cimetidine despite continued administration of aspirin (O'Laughlin et al, 1981). Anti-ulcer medications, including cimetidine, are often used to treat gastrointestinal symptoms produced or aggravated by anti-inflammatory drugs, including ibuprofen.…”