A double-blind randomized controlled study with pirenzepine (75 mg/day), cimetidine (1 g/day) and placebo was performed in 50 consecutive out-patients with duodenal ulcer. The patients also received an antacid containing aluminium hydroxide. Pirenzepine, cimetidine and placebo had similar effects on the 4-week healing rate. Dryness of the mouth was more frequent with pirenzepine than with the other two types of treatment. The incidence of other side effects did not differ in the three groups. A tendency towards more rapid disappearance of subjective symptoms in the patients treated with pirenzepine was not statistically significant. In conclusion, pirenzepine and cimetidine were not superior to placebo in the treatment of duodenal ulcer.
Postoperative reflux gastritis is generally considered a definite clinical syndrome. It is the possible sequel to any gastric surgery suppressing pyloric continence. Incidence of this complication is still difficult to evaluate, whereas enterogastric reflux is often seen during endoscopy. 75 patients were studied clinically and endoscopically, and their gastric mucosa histologically, after gastric surgery. Results were compared to those in a 2nd group of patients whose reflux induced symptoms had been brought under control by endoscopically confirmed surgical correction of reflux. Enterogastric reflux is common (80%), but its effect on the gastric mucosa is observed endoscopically only when it is relatively marked (69%). Clinical suspicion of reflux gastritis is most often confirmed by endoscopy, but endoscopic reflux gastritis is symptomatic in only half of patients undergoing surgery. Foveolar hyperplasia is the only histological criterion related to reflux gastritis.
The effect of pirenzepine and cimetidine on healing, symptoms and relapse rate of duodenal ulcer was studied in a placebo-controlled double-blind trial. Cimetidine (1 g daily) was superior at the beginning of therapy to a low dose of pirenzepine (75 mg daily) and placebo with regard to symptoms. No significant differences in ulcer healing were found between the 3 groups of treatment. The relapse rate after treatment with pirenzepine was lower than after treatment with cimetidine.
