Endoscopic and histological verification of upper GI tract side effects after long-term therapy with alendronate and strontium ranelate

Aim: The aim of the study was to compare the endoscopic and histological changes in the upper GI tract after Aln and Sr treatment in patients with nausea, dysphagia and abdominal pain, which led to discontinuation of the therapy with alendronate (Aln) and strontium ranelate (Sr). Material and methods: 31 postmenopausal women treated with 70 mg/daily Aln or Sr 2.0 g/daily for reporting upper GI tract side effects such as abdominal pain and/or discomfort, nausea and vomiting which led to the discontinuation of the therapy within the last 7 days underwent gastro-duodenoscopy with standardized biopsy. Results: In the whole study group, the most common side effects were dyspepsia and epigastric pain. In the stomach, the most frequent histopathological feature in both Aln and Sr groups was inactive chronic inflammation (p < 0.05). Visible erythema and/or friability were observed in 38% of patients in the Aln group and in 2 patients of the Sr group (20%) (p < 0.05). The frequency of mucosal atrophy was significantly higher in the Sr group (p < 0.05). Conclusions: The incidence of less severe gastric events, such as erythema, mucosal haemorrhages or erosions, was similar in both Aln and Sr groups; however, the occurrence of chronic atrophic gastritis was significantly higher in the Sr group.