GASTRIN PATHOPHYSIOLOGY - ANTISECRETORY DRUGS

The management of maintenance therapy in peptic disease (oesophagus, stomach, duodenum) with antisecretory drugs should keep in consideration the aspect of developing hypergastrinemia: gastrin exerts a throphic effect on gastric ECL and parietal cells. After a long term maintenance therapy (3-5) years) with ranitidine 150mg/die in a group of 55 patients affected by duodenal ulcer, 20% of them developed hypergastrinemia and gastric hypersecretion (evaluated after one week of drug withdrawal). The same 20% of the subjects showed increased relapse rates with respect to those who did develop the same gastrin/gastric acid increase.