Ulcer healing and serum pepsinogen I in cimetidine and glycopyrrolate treated duodenal ulcer patients.

Cimetidine is effective in the treatment of acute duodenal ulcers. 26 endoscopically verified duodenal ulcer patients were treated for four weeks with either cimetidine 0.8 g/day or with the anticholinergic drug glycopyrrolate 4 mg/day on a double-blind basis. Gastroscopical healing was achieved in 10/13 (77%) of cimetidine treated patients and in 4/13 (31%) of glycopyrrolate treated patients (p less than 0.05). There were no major side-effects in either group. In this study cimetidine seemed to be more effective than glycopyrrolate in the treatment of acute duodenal ulcer. The pretreatment level of serum pepsinogen I was elevated (110.1 +/- 42.8 microgram/l; mean +/- SD) in these patients (normal range 20--100 microgram/l) and increased significantly after pentagastrin stimulation to 133.2 +/- 56.4 microgram/l (p less than 0.001). The post-treatment level measured 24 hours after termination of treatment had increased significantly in the cimetidine group but not in the glycopyrrolate group. In the cimetidine group the high pretreatment level of pepsinogen I tended to predict a poor response.