Abolition by omeprazole of aspirin induced gastric

This study investigates whether aspirin injury to the human gastric mucosa can be prevented by profound acid suppression with omeprazole, in a randomised, double blind, crossover design according to latin square. It was concluded that profound acid suppression can prevent aspirin induced gastric mucosal injury in normal subjects. This approach may prevent the development of peptic ulcers and their complications in patients taking aspirin and other non-steroidal anti-inflammatory drugs. Aspirin and non-steroidal anti-inflammatory drugs are strongly associated with peptic ulcer complications in the elderly in Britain. Assuming that the association may be causative, a number of approaches have tried to reduce the extent of damage caused by these agents.6 Although old people appear to be at greatest risk, it is difficult to evaluate possible therapeutic manoeuvres in this population. We have therefore investigated healthy adult volunteers whose acute responses appear to reflect those of older patients.7 Our previous studies show that acid inhibition by ranitidine8 and famotidine9 results in a reduction in gastric mucosal damage, as quantified by the rate of gastric mucosal bleeding and endoscopic appearance, but aspirin induced damage was not totally abolished. In the present study we have examined the hypothesis that gastric acid is necessary for the occurrence of aspirin induced gastric damage. To achieve virtual gastric anacidity we used omeprazole, an irreversible inhibitor of the proton pump in gastric parietal cells.'0 Methods bd for the last 48 h; (c) omeprazole 20 mg each morning for seven days plus aspirin 900 mg bd for the last 48 h; and (d) omeprazole 40 mg bd for seven days plus aspirin 900 mg bd for the last 48 h. The last doses of omeprazole and aspirin (or the corresponding placebo) were taken at 07 00 h and 07 30 h that is, 120 and 90 minutes, respectively, before measurement of gastric blood loss. Each of the above regimens was separated by a seven day washout period. The order of treatments was randomised according to a latin square design and the study conducted in double blind manner.