Abstract
Omeprazole (20mg/day, after breakfast) were administered to six patients with active gastric ulcer, who were endoscopically followed up every two weeks as a rule. The protrusion of the base of the ulcer were found in four of these patients (Table 1). The incidence of the protrusion during the administration of omeprazole might be higher than that with H2 receptor antagonist. With the object of elucidating the high incidence of the protrusion, the 24 hours intragastric pH monitoring, the time course measurement of plasma gastrin levels and the biopsies from the protrusion were performed. In all of five patients who were performed pH monitoring under the administration of omeprazole, the holding time over pH 3 were 100% and the 24 hours mean pH were about seven. On the other hand, among the H2 receptor antagonist (Ranitidine) administered cases, the holding time over pH 3 were about 50% and the 24 hours mean pH were about four (Table 2). There was no statistical difference between the plasma gastrin level and the protrusion of the ulcer base as the result of the time course measurement on one or two weeks during the administration of omeprazole (Figure 7). Histologically, the protrusion was mainly constituted of the granulation tissue and was not due to the epithelial hyperplasia. Namely, the protrusion might result from the proliferation of the granulation tissue after vanishing of peptic action of gastric juice by omeprazole and not from trophic action to the mucosa by secondary hypergastrinemia.
