Hormonal regulation of gastric acid in peptic ulcer disease

Although the pathogenetic role of gastrin in gastric acid hypersecretion and peptic ulcer is well established in a number of uncommon disorders, such as Zollinger-Ellison syndrome, antral G-cell hyperfunction, and retained, excluded antrum after subtotal gastrectomy, the significance of hormonal abnormalities in normogastrinaemic peptic ulcer is less obvious. Most studies have pointed to an impaired feedback mechanism between gastric acid and antral gastrin secretion in duodenal ulcer disease, possibly due to antral somatostatin deficiency. Furthermore, antisecretory drugs may induce abnormalities of gastrointestinal hormones. Potent antisecretory drugs, such as omeprazole, increase serum and antral gastrin and reduce antral somatostatin, whereas certain prostaglandin E2 analogues inhibit serum gastrin secretion after feeding.