After severe thermal injury, acute gastroduodenal mucosal lesions occur in up to 80 per cent of patients. Prior to prophylactic antacid therapy, one-third of these lesions progressed to ulceration, which frequently resulted in major life-threatening hemorrhage. Antacid treatment regimens have dramatically reduced this complication. However, the incidence of occult complications that result in increased morbidity has remained unchanged. We evaluated prospectively a combined treatment regimen using antacid, an H2-receptor antagonist, and enteral feeding in 60 patients who had serious burns (mean burn size, 36% body surface area) in this series. The incidence of both overt and occult complications was 3 per cent and in no patient did a perforation develop nor was operative intervention required. No patient died of the complications of Curling's ulcer. Combination therapy may be of value in other patients prone to stress ulceration.