Abstract
The ulcers in the upper portion of the stomach in which acid secretion is usually low have been considered to be better treated with agents which exert their anti-ulcer effect through mucosal protection. This study was undertaken to assess the effect of cimetidine on the treatment of the ulcers in the upper portion of the stomach. We also examined mucosal prostaglandins and mucosal blood flow in such cases. Cimetidine, unexpectedly, tended to accelerate healing rate compared with that in cases treated with conventional antiulcer agents. Acid secretion in patients with ulcers in the upper portion of the stomach was low in both basal and tetragastrin-stimulated condition. Mucosal PGE2 and PGI2 were also low especially in the corpus in such cases. Furthermore, mucosal blood flow in the corpus tended to be low. These results suggest that hypoacidic condition and low activity of mucosal protection exist in patients with ulcers in the upper portion of the stomach. Therefore, gastric mucosal damages is likely to be induced even in hypoacidic conditions in such cases. In these reasons, strong inhibition of acid secretion (by cimetidine) is thought to be very important in the manage-ment of ulcers even in the upper portion of the stomach.
