MARTIN H. POLESKI, M.D.
To the editor: The second part of Freston's review on Cimetidine (1) does not mention an important point relevant to the gastric carcinoma issue. There is some clinical evidence that a decade or two after surgery for duodenal ulcer disease, there may be an increased incidence of carcinoma in the gastric stump (2, 3). The studies by Reed and associates, as pointed out by Freston, show a positive correlation between gastric pH and increased N-nitrosamine and nitrate levels in gastric juice (4). These studies also show that Cimetidine therapy and vagotomy equally raise N-nitrosamine levels to a small extent, but
POLESKI MH. Cimetidine and Gastric Carcinoma. Ann Intern Med. ;98:673. doi: 10.7326/0003-4819-98-5-673_2
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Published: Ann Intern Med. 1983;98(5_Part_1):673.
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