The role of colloidal bismuth subcitrate in gastric ulcer and gastritis

The pathophysiology of gastric ulcer and gastritis has been related to an increase in damaging factors such as duodeno-gastric reflux and anti-inflammatory drugs. A decreased capacity for mucosal prostaglandin generation is highly likely. Acid secretion is usually normal or even reduced. Colloidal bismuth subcitrate (CBS) has been shown to increase gastric mucosal defence. In controlled trials a clear superiority over placebo has been demonstrated. Amalgamation of the data shows an average healing rate of about 70% in gastric ulcer, which is statistically significantly higher than that for cimetidine in comparative trials. The therapeutic gain (the difference between the healing rate of drug and placebo in a direct comparison) of CBS is high compared with other anti-ulcer agents. In campylobacter gastritis we have shown that the microorganism is very sensitive to CBS, and its eradication results in histological improvement.