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October 25, 1985

Gastroenterology and Hepatology

JAMA. 1985;254(16):2267-2271. doi:10.1001/jama.1985.03360160099021

Although histamine H2-receptor blockers remain the mainstay of therapy for peptic ulcer, the experimental agent omeprazole has proved to be the most potent acid suppressant. Administered once daily, it may suppress gastric acid secretion for up to three days. Clinical trials in Zollinger-Ellison syndrome support the advantage of omeprazole over H2-receptor—antagonist therapy.1 Omeprazole, when compared in a double-blind fashion to cimetidine, has been shown to heal duodenal ulcers more rapidly.2 Limiting enthusiasm for this agent, however, is the development of carcinoid tumors in some rats treated with omeprazole for two years, a finding that led to temporary suspension of European clinical trials.3

Development of gastric carcinoid in 8% of a large group of patients with pernicious anemia, as well as reports of malignant carcinoid complicating the Zollinger-Ellison syndrome, suggests that chronic hypersecretion of gastrin, whether induced by suppression of acid secretion or by