Summary
The different drugs have different indications. Belladonna and Atropin check the secretion of gastric juice considerably, if given before secretion begins, and if administered in proportionate quantities. They help overcome pyloric spasm, and are analgetic. Taken on a full stomach they delay the passage of food.
Alkalis and Alkaline Earths instantly neutralize HCl, reduce secretion and render pepsin ineffective. They have a different effect on the bowel movement. Magnesium and Calcium have a lining effect.
Sodium Bicarbonate has other specific actions. It empties the stomach quickly, by formation of CO2. It has a beneficial effect on the accompanying gastritis. It is harmless if given in doses which are therapeutically sufficient. There can be no danger of alkalosis or subsequent secretion.
Bismuth Subcarbonate absorbs practically no hydrochloric acid, and no pepsin at all, but it is the best protective for the ulcer cavity. Because of its adhesiveness and oily consistency it is beneficial to ulcers and gastritis. It prevents the formation of histaminlike substances in the ulcer cavity.
Colloidal Aluminum Hydroxide and Aluminum Silicate render pepsin ineffective through adsorption They are peptized and gelatinized in the gastric juice, and have a soothing effect similar to that of the colloidal starch solutions and mucilaginous substances. They have a corrosive quality which is perhaps the same as that of the formerly popular silver nitrate. They are not free from after-effects, and should not be taken by the patient on his own responsibility. The same is true for bismuth.
In contrast to aluminum and bismuth preparations, all the alkalis and alkaline earths are perfectly harmless, if taken in the required doses and concentrations. They are not alien substances in the organism. Considerably smaller doses are needed to absorb hydrochloric acid, and, what is more important, to render pepsin ineffective immediately.
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Ehrmann, R. Drugs in the treatment of peptic ulcer and hypersecretion. Jour. D. D. 12, 154–156 (1945). https://doi.org/10.1007/BF02998657
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DOI: https://doi.org/10.1007/BF02998657