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Duodenal ulcer, a condition in which the wall of the small intestine develops painful, sometimes bleeding lesions, is thought to result from an imbalance between the protective effects of the gastrointestinal mucosa (lining) and the destructive effects of hydrochloric acid produced by the stomach. A standard therapeutic approach to the treatment of duodenal ulcer is the administration of drugs that reduced gastric acid secretion. However, there is controversy over what might be the most effective regimen for administration of acid antisecretory or antacid drugs. Additionally, there has been debate over the effectiveness of over-the-counter (OTC) antacid medications which simply neutralize gastric acid (rather than preventing secretion, as most prescription ulcer medications do). A comparative evaluation of the effectiveness of a widely used antisecretory drug (cimetidine, a blocker of histamine H2 receptors) and an OTC antacid (magaldrate) was carried out in a group of 371 consecutive ulcer patients who were being treated at a Brazilian ulcer clinic. The standard therapeutic dose of cimetidine (800 milligrams) was given once per day to one group of patients, and one of three very-low-dose regimens of OTC antacid was given to the other groups of patients. The healing rates in the patients administered antacid were higher at both four and eight weeks than in the cimetidine group. Healing rates in this study were not affected by age, sex, symptoms at entry, presence or absence of night pain, or coffee consumption. In the cimetidine-treated group, smoking was associated with a slower healing rate, but there was no association between smoking status and healing rate in the antacid groups. (Consumer Summary produced by Reliance Medical Information, Inc.)