Omeprazole in duodenal ulceration: acid inhibition, symptom relief, endoscopic healing, and recurrence. Cooperative study.

In a preliminary study to compare the effects of different doses of omeprazole 44 patients with endoscopically diagnosed duodenal ulceration randomly received omeprazole 20 mg, 30 mg, 40 mg, or 60 mg daily for four weeks. After four weeks the ulcer had healed in 41 of the 43 patients who completed the course of treatment; the proportions of patients whose ulcer healed were similar between the four dosage groups. Most patients were symptom free after one week of treatment. Seven patients reported a total of eight adverse events. With the exception of one patient who had persistent nausea and was withdrawn from the study, all the adverse events resolved spontaneously during continued treatment with the same dose of omeprazole. Pentagastrin tests were performed before the study and after four weeks' treatment. The mean inhibition of peak acid output measured 24 hours after the last dose was 61%, 94%, 91%, and 81% with omeprazole 20 mg, 30 mg, 40 mg, and 60 mg respectively. During the first six months after the end of treatment 11 out of 36 patients had a symptomatic, endoscopically diagnosed recurrence of ulceration; the median time to relapse was 10 (range 6-23) weeks.