Intragastric nitrites, nitrosamines, and bacterial overgrowth during cimetidine treatment.
Open Access
- 1 December 1982
- Vol. 23 (12), 1048-1054
- https://doi.org/10.1136/gut.23.12.1048
Abstract
A six week course of cimetidine (1 g/day) healed peptic ulcers in 20 of 23 patients (14 with duodenal ulcer, nine with gastric ulcer). Reduction of basal acid output by 73% and peak acid output by 36% led to a rise in concentrations of intragastric aerobic bacteria and nitrate-reducing bacteria. While the mean intragastric concentration of nitrate was unchanged by treatment, there were statistically significant rises in nitrite and N-nitrosamine concentrations. The conversion from nitrates to nitrites was closely related to the occurrence of nitrate-reducing bacteria. In three patients the intragastric milieu had returned to normal two months after cimetidine treatment had been discontinued. Mean nitrite and N-nitrosamine concentrations did not return to pre-treatment levels in the group of eight patients who remained on maintenance cimetidine (0.4 g at night-time) for three months after the full dose treatment. This study shows that cimetidine treatment can create an intragastric milieu resembling that of atrophic gastritis. Large scale and long-term studies are necessary to establish whether these findings have any clinical significance.Keywords
This publication has 24 references indexed in Scilit:
- CIMETIDINE IS UNLIKELY TO INCREASE FORMATION OF INTRAGASTRIC N-NITROSO-COMPOUNDS IN PATIENTS TAKING A NORMAL DIETThe Lancet, 1981
- CIMETIDINE, DELAY IN DIAGNOSIS, AND CARCINOMA OF THE STOMACHThe Lancet, 1980
- Cimetidine-induced bone marrow suppressionDigestive Diseases and Sciences, 1980
- CIMETIDINE AND GASTRIC CANCERThe Lancet, 1979
- MISLEADING RESPONSE OF MALIGNANT GASTRIC ULCERS TO CIMETIDINEThe Lancet, 1978
- Determination of a non-volatile N-nitrosamine on a food matrixThe Analyst, 1978
- Effect of cimetidine on 24-hour intragastric acidity in normal subjects.Gut, 1976
- A rapid cadmium reduction method for the determination of nitrate in bacon and curing brinesThe Analyst, 1971
- Positioning of Subject and of Nasogastric Tube during a Gastric Secretion StudyBMJ, 1970
- Pernicious Anemia and Gastric Carcinoma.Acta Medica Scandinavica, 1959