Absorption of bismuth from two bismuth compounds before and after healing of peptic ulcers.

ABSTRACT

BACKGROUND/AIMS: Previous reports state that there is absorption of bismuth through active peptic ulcers. It was therefore of interest to investigate the extent of absorption in patients at the ulcer and post-ulcer stages. METHODOLOGY: Twenty H. pylori-positive patients with gastroscopically verified gastric or duodenal ulcers were randomly allocated to ingest 3000 mg bismuth subnitrate (BSN) (10 patients) or 480 mg colloidal bismuth subcitrate (CBS) (10 patients). Bismuth serum concentration in 12 samples drawn during the first 4 hours after drug intake was analyzed and the area under the curve (Bi-AUC) was calculated. Anti-H. pylori therapy with amoxicillin and lanzoprazole eradicated H. pylori in 10 patients and healed the ulcers in all patients 4 weeks after therapy ended, then the bismuth absorption test was repeated. RESULTS: There was no significant difference between ulcer- and post-ulcer Bi-AUC for patients receiving BSN or for patients receiving CBS. On a molar basis, CBS gave a 17.4-fold greater absorption of bismuth compared to BSN. CONCLUSIONS: The presence of an active ulcer does not significantly influence the absorption of bismuth from CBS or BSN.