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Duodenitis: a preulcer state.

To the Editor. —Whether duodenitis is an entity or a part of a chronic duodenal ulcer disease is still an unclear issue. " We examined prospectively the clinical, endoscopic, and histologic features in patients with duodenitis before and after cimetidine hydrochloride therapy. Severe duodenitis, with no ulcer crater, was found endoscopically in seven men and three women with dyspeptic complaints. Barium-meal study showed no abnormalities. Clinical, endoscopic, and histologic scoring (0 to 3), as described elsewhere, 2 was performed at the time of the first and second endoscopy (six weeks after treatment with cimetidine, 1 g/d). Statistically significant improvement was found in all the above parameters (Figure, Table). These results support the hypothesis that duodenitis is a part of chronic duodenal ulcer disease, and so improvement is the rule when hypoacidity or anacidity is achieved. A randomized, prospective study is needed to confirm our results.