A bismuth-peptide complex (BCP Compound), an antacid (Maalox) and corresponding placebos were studied in a 6-week comparative double-blind trial of treatment in 106 randomized ambulant patients with endoscopically proven duodenal and gastric ulcers. Patients were examined after 1, 3 and 6 weeks' treatment and results assessed separately for duodenal and gastric ulcers on endoscopic evidence at weeks 3 and 6 respectively. Bicitropeptide was significantly better than antacid and placebo at 3 and 6 weeks for treatment of both duodenal and gastric ulcers. In the bicitropeptide group 100% of the patients in the duodenal ulcer group and 95,2% in the gastric ulcer group responded to treatment (improved or healed). No haematological or biochemical changes were noted and no adverse effects were recorded.
The effect of intravenous and intramuscular administration of diazepam on secretin- and cholecystokinin-stimulated pancreatic secretion was studied in man. Diazepam was not found to have a significant effect on mean volume out-put, bicarbonate and enzyme concentrations and colour index. It was acceptable as premedication for routine pancreatic function studies.
The value of emergency upper gastrointestinal fibre-endoscopy, followed where required by the use of a modified Sengstaken tube, was studied during 84 episodes of acute bleeding in 75 patients who had evidence of portal hypertension with varices. The portal hypertension was due to alcoholic cirrhosis in 80% and to cryptogenic cirrhosis in 9% of the patients. By definition, varices were present in all patients, but in only 66% of episodes were the varices the cause of the bleed. The correct diagnosis of the source of bleeding was made at endoscopy in 89%. A Boyce modification of the Sengstaken-Blakemore tube was passed in 73% of the episodes of variceal bleeding. It effectively stopped the bleeding primarily in 85% of patients but was successful as a final definitive measure only in 46%. Furthermore, only 40% of the patients in whom the tube was passed, survived. Mortality rate could be related to the severity of the bleed and to hepatocellular dysfunction. Survival increased from 23% in those patients with jaundice, ascites, and encephalopathy on admission to 92% in those without these manifestations. The in-hospital survival rate was 52% in patients bleeding from varices and 64% in those bleeding from other causes, with an overall survival rate of 56%, indicating the poor prognosis in cirrhotic patients with gastrointestinal bleeding, irrespective of the cause.
A new antidiarrhoeal compound, loperamide (Imodium; (Janssen) Ethnor) has been evaluated in the treatment of patients with chronic nonspecific diarrhoea. In a double-blind trial its effect was compared with that of a placebo. The results of this trial indicate that loperamide is an effective antidiarrhoeal compound.
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