Does Sucralfate Reduce Acetylsalicylic-Acid-Induced Gastric Mucosal Bleeding?

Abstract

We studied the possible protection of sucralfate with regard to acetylsalicylic acid (ASA)-induced gastric mucosal bleeding as measured by a radiochromium assay of faecal blood loss in a double-blind crossover study involving 16 healthy male volunteers. Medication was given in two combinations during the 2nd and 5th week of the study: 1 g ASA and 1 g sucralfate four times daily, or 1 g ASA four times daily and placebo tablets. Mean faecal blood loss (± SEM) was 0.38 ± 0.04 ml/day in the 1st week (no drugs administered), 7.17 ± 1.60 ml/day during treatment with ASA + sucralfate, and 9.59 ± 1.76 ml/day during treatment with ASA + placebo, the difference being not statistically significant. Individual bleeding values registered during sucralfate treatment correlated with those measured in the placebo period. However, three persons with pronounced bleeding after ASA + placebo had minimal bleeding after ASA + sucralfate. Sucralfate may have a protective potential by reducing ASA-induced gastric mucosal bleeding, but further studies are required to evaluate its protective mechanisms and to identify the groups of patients that could benefit from this.

Key Words:

• Acetylsalicylic acid
• anti-inflammatory agents
• bleeding
• upper gastrointestinal
• prophylactic effect
• sucralfate