Gastric retention of enteric-coated sulfasalazine tablets. A complication of gastroduodenal Crohn's disease.

A case is described in which a patient with known gastroduodenal Crohn's disease developed a picture of gastric outlet obstruction accompanied by gastric retention of many enteric-coated sulfasalazine tablets. The tablets were removed by gastric lavage with a sodium bicarbonate solution. Following this observation, an in vitro study was done in which the rate of disintegration of enteric-coated sulfasalazine tablets was found to be directly related to pH. The case report reveals a potential hazard in using enteric-coated tablets in patients with impaired gastric emptying. Intragastric sodium bicarbonate may be a useful element in the management of this complication.