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Changes in intragastric bile acid composition in patients receiving cimetidine postoperatively
G C Vitale1, Y Siow, W G Cheadle
1Department of Surgery, University of Louisville School of Medicine, Kentucky 40292.
American Journal of Surgery
|January 1, 1990
Summary
Cimetidine alters bile salt composition in gastric reflux, decreasing toxic acids and increasing less toxic ones. This may explain its benefits for gastritis beyond acid reduction.
Area of Science:
- Gastroenterology
- Pharmacology
- Biochemistry
Background:
- Enterogastric reflux is linked to gastritis, particularly after gastrectomy or with an intact pylorus.
- Bile acids are implicated in the pathogenesis of gastritis due to their potential toxicity.
Purpose of the Study:
- To investigate the impact of cimetidine on bile acid concentration and composition in gastric aspirates.
- To determine if cimetidine's effects on bile acids contribute to its therapeutic benefits in gastritis.
Main Methods:
- Prospective randomized study involving 27 patients receiving intravenous cimetidine and 25 receiving placebo.
- Analysis of gastric aspirates using high-performance liquid chromatography for bile acid composition and spectrophotometry for total concentration.
Main Results:
- Cimetidine significantly decreased glyco-chenodeoxycholic acid, a toxic dihydroxy bile acid.
- The ratio of less toxic trihydroxylated to more toxic dihydroxylated bile acids increased significantly in the cimetidine group.
- Enterogastric reflux and total bile acid concentration remained unchanged by cimetidine.
Conclusions:
- Cimetidine modifies bile salt composition, favoring less toxic forms.
- These alterations in bile acid profile may contribute to cimetidine's beneficial effects in gastritis, independent of its acid-suppressing action.