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Henry Ford Hospital Medical Journal

Abstract

Choline salicylate is the anhydrous choline salt of salicylic acid. It possesses the therapeutic effects of aspirin. Clinical trials suggest that it is less irritating to the gastric mucosa. A double-blind gastroscopic study of the acute effects on the gastric mucosa of choline salicylate, aspirin and matching placebo was carried out. Using the fiberoptic gastroscope. the stomach was examined and photographed before, and ten minutes after, the patient had swallowed the tablets. Results were evaluated on the basis of combined endoscopic and photographic observations. This study suggests that choline salicylate in its tablet form causes less gastric mucosal injury than aspirin. 'This may be due to its extreme solubility, to a relatively higher pH in solution, and to the absence of the acetyl radical in its molecular structure. Gastroscopic evaluation of acute local reaction of the mucosa to drugs is better accomplished by the combined use of endoscopic and photographic observations and by the inclusion of a placebo in the study protocol. Presence of peptic ulcer or other mucosal abnormality does not necessarily increase the susceptibility of the gastric mucosa to aspirin or choline salicylate injury.

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