Treatment of gastric pyrosis with almagate in patients with and without endoscopically demonstrable duodenal ulcer. A multicentre clinical trial.

An open multicentre trial of a new clinical antacid, almagate (hydrated aluminium-magnesium hydroxycarbonate, Al2Mg6(OH)14(CO3)2 X 4H2O, Almax) has been made in 169 patients suffering from gastric pyrosis (heartburn). Clinical and endoscopical exploration revealed that 104 of the patients had an active duodenal ulcer and 60 of these (group II) were treated with antisecretory drugs (cimetidine or ranitidine) plus Almax and 44 (group III) with Almax alone. Endoscopic exploration in the remaining 65 patients (group I) failed to reveal the presence of an ulcer and they were also treated with Almax alone. In all groups Almax proved to be very effective and the majority of patients were symptom free by the end of the two week trial. 79.5% of the ulcer patients in group III required doses of 6-8 g/d whereas only 21.7% of those in group II with concomitant treatment with antisecretory drugs took more than 4 g/d. The nonulcer patients of group I also used lower doses and only 29.3% needed to reach 6-8 g/d. There was a significant increase in daily bowel movements in all groups which was considered to be advantageous by most patients. Overall tolerance was excellent and side effects (diarrhoea 7 cases, nauseas 5 cases and constipation 1 case) were few and transient and 84.2% of the patients expressed a clear preference for Almax over their previous antacid treatment.