Various bismuth chelates and complexes, such as sucralfate, eﬀective in healing gastric and duodenal ulcers are available. They may act by a direct toxic eﬀect on gastric HELICOBACTER PYLORI, or by stimulating mucosal prostaglandin (see PROSTAGLANDINS) or bicarbonate secretion. Healing tends to be longer than with H2-RECEPTOR ANTAGONISTS and relapse still occurs. New regimens are being developed involving co-administration with antibiotics. ENCEPHALOPATHY, described with older high-dose bismuth preparations, has not been reported.
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