Abstract
A high incidence of gastric ulceration is reported in patients with rheumatoid arthritis and in addicts taking large doses of aspirin. In rheumatoid arthritis a serum salicylate level of 15 mg% is considered to be therapeutic. We studied gastric mucosal permeability to ions in 9 healthy subjects given 3 g aspirin intravenously over 2 hours (mean serum salicylate, 17 mg%). Atropine was injected intravenously to reduce acid secretion which masks H+ loss. H+ and Na+ fluxes during aspirin infusion were not significantly different from those during intravenous saline infusion. Thus, high blood levels of salicylates did not impair the gastric mucosal barrier. Intragastric salicylic acid following intravenous aspirin infusion increased gastric mucosal permeability to H+ and Na+ ions. Under the conditions of these studies the effect was more marked in males. Gastric absorption of salicylic acid was similar in males and females, and the amount absorbed was unaffected by the presence of high blood levels of salicylates. Absorption of salicylic acid was significantly greater in the first period of salicylic acid instillation (mean, 28%) than in the second (mean, 21%) and third (mean, 16%) periods. Percentage absorption of undissociated salicylic acid was at least three times greater than that of H+ ions.
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