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Ingredients used in Pepstat-380 © are well researched. Laboratory testing has shown that the ingredients in Pepstat:

  • Repair and increase the number of cells that form the 'protective' mucosal lining.
  • Increase blood flow to the lining of the intestinal tract, thus preventing future damages.
  • Create mucin, (protective substance) which lines the stomach and intestines.
  • Soothes indigestion.
  • Calcium neutralizes excess acid.
  • Digestive enzymes help the digestive process.

Pepstat-380 0002

Research on ingredients: Eur J Pharmacol 1981 Jun 19;72(2-3):219-25
Deglycyrrhizinised liquorice (DGL) and the renewal of rat stomach epithelium.
van Marle J, Aarsen PN, Lind A, van Weeren-Kramer J.

Deglycyrrhizinised liquorice (DGL) stimulated proliferation in the forestomach of the rat but did not stimulate and possibly even inhibited proliferation in the glandular part. DGL increased the number of fundus glands in which labelled mucus secreting cells occur as well as the total number of labelled mucus cells per gland. The mechanism of action proposed for DGL is that DGL stimulates and/or accelerates the differentiation to glandular cells as well as mucus formation and secretion. The accelerated proliferation observed in the forestomach is ascribed to an improved environment in the stomach as a consequence of the enhanced mucus secretion under the influence of DGL.

1: J Pharm Pharmacol 1994 Feb;46(2):148-9
Practitioner 1975 Dec;215(1290):787-92
Deglycyrrhizinized liquorice in the treatment of chronic duodenal ulcer. A retrospective endoscopic survey of 32 patients.
Larkworthy W, Holgate PF

Endoscopic examination in 32 cases of chronic duodenal ulceration treated with deglycyrrhizinized liquorice tablets showed that healing of the ulceration had occurred and in the majority the mucosa appeared normal. For optimum effect it appears to be important that the preparation in adequate dosage should be well chewed and swallowed on an empty stomach in the ambulant patient.

The protective effect of liquorice components and their derivatives against gastric ulcer induced by aspirin in rats.
Dehpour AR, Zolfaghari ME, Samadian T, Vahedi Y Darou Pakhsh Pharmaceutical Research Center, Tehran, Iran.

We have examined the protective effect of liquorice or its derivatives against gastric ulcer induced by aspirin. A granular mixture of aspirin alone and coated with liquorice or its derivatives including the deglycyrrhized form, a high glycyrrhized form, carbenoxolone, and enoxolone were studied. Aspirin coated with liquorice reduced the number and size of ulcers, reducing the ulcer index from 1.5 +/- 0.12 to 0.5 +/- 0.12 and the incidence from 96% to 46%. Coating with derivatives was less effective (ulcer index, 0.70-0.94; incidence 62-76%).

Eur Neurol 1992;32(1):44-51
Glycyrrhizin (licorice)-induced hypokalemic myopathy. Report of 2 cases and review of the literature.
Shintani S, Murase H, Tsukagoshi H, Shiigai T Department of Neurology, Toride Kyodo General Hospital, Ibaraki, Japan.

Fifty-nine cases of glycyrrhizin (licorice)-induced hypokalemic myopathy (GIHM), 2 females treated in our departments (85 and 73 years old) and 57 cases reported in the literature were studied, and conditions leading to the onset, factors, clinical manifestations, laboratory assessments, muscle biopsy findings, treatment and outcome were discussed. The 59 GIHM cases comprised 32 men, 25 women and 2 patients without record of sex; the average age was 55.2 years. In many cases, conditions leading to the onset of GIHM were habitual licorice ingestion, ingestion of antituberculosis agents containing licorice and long-term ingestion of licorice-containing agents for chronic gastritis, chronic hepatitis or chronic dermatitis. The combined use of hypotensive diuretic agents increased the risk of GIHM in an overwhelming number of cases. The main clinical symptom was flaccid quadriplegia in almost all cases, with muscle pain in 32.2% and peripheral dysesthesia in the extremities, manifested mainly by numbness (27.1%). Laboratory findings included a mean serum K+ value of 1.98 mEq/l (56 GIHM cases), a mean creatine kinase of 5,385.7 IU/l (n = 30), a mean blood aldosterone concentration of 2.92 ng/dl (n = 30; normal: 2.0-13.0 ng/dl) and a mean plasma renin activity of 0.17 ng/ml/h (n = 27; normal: 0.8-4.4 ng/ml/h). Muscle biopsy was performed in 17 of the 59 cases with resultant findings of myopathic changes consisting mainly of phagocytosis, necrotic fibers, vacuolar degeneration, together with sporadic neurogenic changes. Complete cure was attained in 57 of the 59 cases of GIHM by discontinued ingestion of glycyrrhizin (licorice) and potassium supplement.

Vutr Boles 1987;26(3):56-9
[Erosive gastritis and gastroduodenitis--clinical, diagnostic and therapeutic studies].
Kolarski V, Petrova-Shopova K, Vasileva E, Petrova D, Nikolov S

Diagnostic, clinical and therapeutic studies were carried out, under clinical conditions, on 80 patients with endoscopically confirmed chronic erosive gastritis and gastroduodenitis. The subjects aged between 20 and 59 are most often affected, the males being 2 times more often affected. The histological study on the purposeful biopsy of the mucosa of the stomach and duodenum established, most frequently, the presence of chronic superficial gastritis and duodenitis, followed by initial chronic atrophic gastritis. The clinical symptoms were studied in details--pain (91.20%), dyspeptic syndrome (83.7%), hemorrhagic manifestations (hematemesis or melena)--23.7%. In 40% of the patients with erosive gastritis and gastroduodenitis, the disease was combined with duodenal ulcer and in 7.5%--with gastric ulcer. The etiological factors of importance are: food factors, dietetic errors, alcoholic consumption, drug effects (first of all derivatives of Rauwolfia serpentina, followed by the peroral broad spectrum antibiotics, etc), duodenogastric reflux and toxic effect of the bile acids on the antral mucosa. The endoscopic studies are of decisive importance for the diagnosis and determining the effect of the treatment. The treatment with a dietetic regimen, gastro-protective drugs (almagel, preparations of deglycyrrhized licorice--alcid V, vitamin A, spasmolytics) eliminated the erosive alterations in 75% of the patients after 3-week treatment.

Scand J Gastroenterol Suppl 1984;92:97-100
Studies on the protective effect of deglycyrrhinised liquorice against aspirin (ASA) and ASA plus bile acid-induced gastric mucosal damage, and ASA absorption in rats.
Russell RI, Morgan RJ, Nelson LM

By per-oral intubation of the stomach, four groups of rats (n = 22) received ASA 64 mg/kg, alone or with taurodeoxycholic acid (TDC, 5 mM), DGL (2000 mg/kg) or TDC plus DGL. At four hours the severity of bleeding was assessed by a lesion scoring system and expressed as medians and quartiles. In a separate study two groups of rats (n = 7) received ASA (128 mg/kg) or ASA plus DGL (2000 mg/kg) and salicylate levels measured in serial tail blood samples at 20, 40, 60 and 80 minutes. Lesion scores were increased from 6(3;10) with ASA alone to 12(5;16) by TDC (p less than 0.05) and reduced by DGL to 1(0;3.5) for ASA alone and 3.5(0;6) for ASA plus TDC (p less than 0.0005 in both cases). In the second study a slight reduction of ASA absorption was found only at 20 minutes with a median level of 0.9 mmol/l for the DGL treated rats and 1.2 mmol/l for the ASA alone group (p less than 0.05). No differences were found at the other times. We have also demonstrated that although DGL diminished ASA (128 mg/kg)-induced gastric mucosal damage from 17(12;25) to 8(3;14) (p less than 0.005) when the two were given together it did not do so significantly when DGL was given before ASA--15(20;22). Intraperitoneal DGL reduced lesion scores from ASA (128 mg/kg) from 14(11;24) to 7(1;19) (p less than 0.03), thus indicating a systemic as well as a local effect of the drug.

Jpn J Pharmacol 1982 Feb;32(1):23-7
Effects of FM100, a fraction of licorice root, on serum gastrin concentration in rats and dogs. Ishii Y, Fujii Y

The effects of FM100, a fraction of licorice root with antiulcer activity, on serum gastrin concentration were investigated in rats and dogs. The basal serum gastrin concentration in conscious rats was not affected by 400 mg/kg. p.o. of FM100, but was increased by 800 mg/kg, p.o. of FM100. The serum gastrin concentration of rats in which the antrum had been separated from the fundus was decreased by intraduodenal administration of FM100 in a dose-dependent manner. In conscious beagles, the increase in serum gastrin concentration induced by feeding was not affected by pretreatment with 400 mg/kg p.o. of FM100. However, in anesthetized dogs in which the antrum had been separated from the fundus, the increase in acid output and serum gastrin concentration after administration of peptone solution was prevented by the intraduodenal administration of 200 mg/kg of FM100. These results suggest that the gastric anti-secretory action of FM100 may be due to the inhibition of endogenous gastrin release.

Scand J Gastroenterol 1979;14(5):605-7
Effect of deglycyrrhizinated liquorice on gastric mucosal damage by aspirin.

Rees WD, Rhodes J, Wright JE, Stamford LF, Bennett A Gastric mucosal damage induced by giving 60 mg aspirin orally to rats was reduced by simultaneous administration of 100-500 mg deglycyrrhizinated liquorice. Human faecal blood loss induced by 975 mg aspirin orally three times a day was less when 350 mg deglycyrrhizinated liquorice was given with each dose of aspirin.

Br Med J 1978 Nov 11;2(6148):1323-6
Cimetidine: an advance in gastric ulcer treatment?
Morgan AG, McAdam WA, Pacsoo C, Walker BE, Simmons AV

Sixty patients with endoscopically confirmed gastric ulceration took part in a single-blind trial of cimetidine 1 g daily compared with conventional treatment--namely, carbenoxolone in patients aged under 60 and Caved-(S) in those over 60. Twenty-nine patients received cimetidine: in 12 (41%) ulcer healing was complete after one month, in 26 (90%) healing was complete after two months, and all ulcers were healed after three months of treatment. In the under-60s, ulcers were healed in a greater proportion of patients given cimetidine than in those given carbenoxolone. The difference, however, was significant only at the 5% level, which owing to small numbers was of doubtful clinical validity. In the over-60s cimetidine and Caved-(S) were of similar efficacy. The 54 patients with healed ulcers are being followed up for two years; so far there have been 16 recurrences (30%). Further trials are needed, which should include maintenance treatment aimed at lowering the unacceptably high recurrence rate.
Prophylaxis with deglycyrrhizinised liquorice in patients with healed gastric ulcer. Br Med J. 1978 Jan 21;1(6106):148.

Fortschr Med 1976 Feb 19;94(16):343-6
[Therapy of ulcus ventriculi with Caved-S. Use of the gastrocamera for diagnosis and control of therapy].
Mittelstaedt A, Schwick M

36 patients with a ventricular ulcer demonstrated by endoscopy and secured by histology, were given 2 tablets Caved-S 4 times a day for 4 weeks. Clinical parameters were subjective complaints, such as pain and heartburn, which after a relatively short time, many patients declared to have diminished or ceased completely. Objective parameters were endoscopic explorations before beginning of the treatment, i.e. gastroscopy and biopsy, examinations by gastro-camera and in some cases chromography to exclude a possible malignancy. The control examinations were performed almost exclusively by gastro-camera, and that after 2 and 4 weeks. The ulcer healing stage could be clearly defined after Ohmori and Miwa (1971), its localisation and size were also recorded. Altogether it can be said, that the preparation Caved-S, by a working-principle not as yet exactly defined in all details, effects rapid healing endoscopically provable, but that ulcers with a special localisation, e.g. in the angulus-area of the posterior wall, require a longer healing time according to expectation. Clinically relevant side effects were not observed. Thus it can be concluded that Caved-S is very suitable for the treatment of ventricular ulcers. The preparation has a spasmolytical component leading quickly to freedom from pain, and a protective component effecting a healing tendency which can be demonstrated by endoscopic methods. It must be said, however, that this protective healing-promoter factor has not yet been defined pharmacologically.

Vutr Boles 1975;14(4):101-6
[Clinical trial of the preparation Caved S in treating peptic ulcer].
Brailski KH, Kadiian KH, Bozhiianov V

The observations upon the therapeutic effect of Caved S preparation are reported, being a combination of deglycyrrhizinated liquorice, alkalizing substances and vagolytic drugs. The clinical trial of the medicine reveals it to be with a quick effect on the subjective complaints good tolerance and no manifested disturbances on water and electrolyte balance. It is suitable for the treatment of patients with gastric and duodenal ulcers. Ulcer niche roentgenologically is healed in 37,5% of the patients with gastric ulcer and in 33% in the patients with duodenal ulcer. Endoscopically, the niche is healed in 25% of the patients with gastric ulcer and in 28,5%--with duodenal ulcer. The medicine is with no effect in cases of gastric callous ulcer, as well as with pyloric stenosis.

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1: Das SK, Das V, Gulati AK, Singh VP. Deglycyrrhizinated liquorice in aphthous ulcers. J Assoc Physicians India. 1989 Oct;37(10):647.
2: Marks IN. Site-protective agents. Baillieres Clin Gastroenterol. 1988 Jul;2(3):609-20.
3: Bennett A, Melhuish PB, Stamford IF. Carbenoxolone and deglycyrrhized liquorice have little or no effect on prostanoid synthesis by rat gastric mucosa ex vivo. Br J Pharmacol. 1985 Nov;86(3):693-5.
4: Marks IN, Boyd E. Mucosal protective agents in the long-term management of gastric ulcer. Med J Aust. 1985 Feb 4;142(3):S23-5. No abstract available.
5: Russell RI, Morgan RJ, Nelson LM. Studies on the protective effect of deglycyrrhinised liquorice against aspirin (ASA) and ASA plus bile acid-induced gastric mucosal damage, and ASA absorption in rats. Scand J Gastroenterol Suppl. 1984;92:97-100.
6: Bennett A. Gastric mucosal formation of prostanoids and the effects of drugs. Acta Physiol Hung. 1984;64(3-4):215-7.
7: Morgan RJ, Nelson LM, Russell RI, Docherty C. The protective effect of deglycyrrhinized liquorice against aspirin and aspirin plus bile acid-induced gastric mucosal damage, and its influence on aspirin absorption in rats. J Pharm Pharmacol. 1983 Sep;35(9):605-7. No abstract available.
8: Glick L. Deglycyrrhizinated liquorice for peptic ulcer. Lancet. 1982 Oct 9;2(8302):817.
9: van Marle J, Aarsen PN, Lind A, van Weeren-Kramer J. Deglycyrrhizinised liquorice (DGL) and the renewal of rat stomach epithelium. Eur J Pharmacol. 1981 Jun 19;72(2-3):219-25.
10: Bennett A, Clark-Wibberley T, Stamford IF, Wright JE. Aspirin-induced gastric mucosal damage in rats: cimetidine and deglycyrrhizinated liquorice together give greater protection than low doses of either drug alone. J Pharm Pharmacol. 1980 Feb;32(2):151.
11: D'Imperio N, Giuliani Piccari G, Sarti F, Soffritti M, Spongano P, Benvenuti C, Dal Monte PR. Double-blind trial in duodenal and gastric ulcers. Cimetidine and deglycyrrhizinized liquorice. Acta Gastroenterol Belg. 1978 Jul-Aug;41(7-8):427-34.
12: Nussbaumer U, Landolt M, Rothlisberger G, Akovbiantz A, Keller H, Weber E, Blum AL, Peter P. [Postoperative stress hemorrhage: ineffective prevention with pepsin inhibitor and deglycyrrhizinized licorice extract. Prospective study] Schweiz Med Wochenschr. 1977 Feb 26;107(8):276-9. German.
13: Baas EU, Holtermuller KH, Sinterhauf K, Walter U. [Behavior of gastrin, renin, aldosterone and electrolytes after administration of deglycyrrhizinized liquorice and carbenoxolone in healthy subjects] Z Gastroenterol. 1976 Apr;14(2):273-6. German.
14: Larkworthy W, Holgate PF. Deglycyrrhizinized liquorice in the treatment of chronic duodenal ulcer. A retrospective endoscopic survey of 32 patients. Practitioner. 1975 Dec;215(1290):787-92.
15: Aarsen PN. Standardization method of deglycyrrhizinized liquorice on experimental gastric ulcers in rats. Arzneimittelforschung. 1973 Sep;23(9):1346-8.
16: Hakanson R, Liedberg G, Oscarson J, Rehfeld JF, Stadil F. Effect of deglycyrrhizinized liquorice on gastric acid secretion, histidine decarboxylase activity and serum gastrin level in the rat. Experientia. 1973 May 15;29(5):570-1
17: Whiting B, Thomson TJ. Deglycyrrhizinized liquorice in duodenal ulcer. Br Med J. 1971 Oct 2;4(778):48.
18: Andersson S, Barany F, Caboclo JL, Mizuno T. Protective action of deglycyrrhizinized liquorice on the occurrence of stomach ulcers in pylorus-ligated rats. Scand J Gastroenterol. 1971;6(8):683-6.

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