Gastric acid hypersecretory states: recent insights and advances

Curr Gastroenterol Rep. 2009 Dec;11(6):433-41. doi: 10.1007/s11894-009-0067-6.


Gastric acid hypersecretory states are characterized by basal hypersecretion of gastric acid and historically include disorders associated with hypergastrinemia, hyperhistaminemia, and those of unknown etiology. Although gastric acid secretion is infrequently measured, it is important to recognize the role of gastric hypersecretion in the symptoms of these disorders because they share several features of pathogenesis and treatment. In this article, recent important articles reporting insights into their diagnosis, pathogenesis, and treatment are reviewed. Particular attention is paid to Zollinger-Ellison syndrome, because it has the most extreme acid hypersecretion of this group of disorders and because numerous recent articles deal with various aspects of the diagnosis, molecular pathogenesis, and treatment of the gastrinoma itself or the acid hypersecretion. Two new hypersecretory disorders are reviewed: rebound acid hypersecretion after the use of proton pump inhibitors and acid hypersecretion with cysteamine treatment in children with cystinosis.

Publication types

  • Research Support, N.I.H., Intramural
  • Review

MeSH terms

  • Cystamine / adverse effects
  • Cystamine / therapeutic use
  • Cystinosis / drug therapy
  • Enzyme Inhibitors / adverse effects
  • Enzyme Inhibitors / therapeutic use
  • Gastric Acid / metabolism*
  • Gastrins / metabolism
  • Histamine / metabolism
  • Humans
  • Proton Pump Inhibitors / adverse effects
  • Stomach Diseases / chemically induced*
  • Stomach Diseases / diagnosis
  • Stomach Diseases / physiopathology*
  • Stomach Diseases / therapy
  • Zollinger-Ellison Syndrome / physiopathology


  • Enzyme Inhibitors
  • Gastrins
  • Proton Pump Inhibitors
  • Histamine
  • Cystamine