The Influence of Full and Low Doses of Nocturnal Cimetidine on Gastric Emptying and Acidity in Duodenal Ulcer Patients

Abstract

Fifty-three patients with endoscopically proven duodenal ulcers (DU) were treated with cimetidine and randomly divided into two groups to receive a single dose of 800 mg (group 1, n=26) or a low dose of 400 mg (group 2, n=27) of cimetidine nocturnally for 8 weeks. The healing rates of DU at the fourth and eighth week in group 1 (53.8% and 73.1%) and group 2 (55.6% and 74.0%) were comparable. The gastric emptying half-time (GET½) of liquid in each of these two groups before and after eight weeks treatment showed no significant changes compared with the control subjects. There was a slight decrease of the mean GET½ in the unhealed than the healed DU patients but this difference did not reach clinical significance. There were also no statistical differences in the intra gastric pH, serum pepsinogen-I and gastrin before and after the two cimetidine regimens or between the healed and unhealed DU after their treatment for eight weeks. The adverse variables which significantly affected DU healing were cigarette smoking and occurrence of nocturnal epigastric pain. In this study, we concluded that a nocturnal low dose of cimetidine was equally effective for the healing of DU. The gastric emptying, day-time acidity as measured through endoscopic gastric aspirate, serum pepsinogen-I and gastrin were not affected by nocturnal acid suppression with cimetidine.