Review article: From gastrin to gastro-oesophageal reflux disease – a century of acid suppression P. MALFERTHEINER*, R. FASS  , E. M. M. QUIGLEY à , I. M. MODLIN§, J. R. MALAGELADA – , S. F. MOSS**, G. HOLTMANN   , K.-L. GOH àà , P. KATELARIS§§, V. STANGHELLINI –– , N. J. TALLEY***, G. N. TYTGAT    & N. A. WRIGHT ààà *Otto von Guericke University, Magdeburg, Germany;  Southern Arizona VA Health Care System and University of Arizona Health Sciences, Tucson, AZ, USA; àUniversity College, Cork, Ireland; §Yale University, New Haven, CT, USA; –University Hospital, Vall d’Hebron, Autonomous University of Barcelona, Barcelona, Spain; **Rhode Island Hospital and Brown University, Providence, RI, USA;   University of Adelaide, Adelaide, South Australia, Australia and Center, Tucson, AZ, USA; ààUniversity of Malaya, Kuala Lumpur, Malaysia; §§University of Sydney, Sydney, New South Wales, Australia; ––University of Bologna, Bologna, Italy; ***Mayo Clinic and Mayo Foundation, Rochester, MN, USA;    University of Amsterdam, Amsterdam, the Netherlands; àààBart’s and The London & Queen Mary’s School of Medicine & Dentistry, London University, London, UK Correspondence to: Dr P. Malfertheiner, Department of Gastroenterology, Hepatology and Infectious Diseases, Otto-von-Guericke University Magdeburg, Leipziger Str. 44, 39120 Magdeburg, Germany. E-mail: peter.malfertheiner@medizin. uni-magdeburg.de Publication data Submitted 7 December 2005 First decision 14 December 2005 Resubmitted 21 December 2005 Accepted 21 December 2005 SUMMARY To commemorate Edkins’ discovery of gastrin in 1905, we review a cen- tury of progress in the physiology and pathobiology of gastrin and acid secretion especially as it pertains to clinical aspects of gastro-oesopha- geal reflux disease. Although initially ignored, Edkins’ observations eventually led to the enthusiastic investigation of gastrin and acid regulation in peptic ulcer disease, culminating in important therapeutic advances in the manage- ment of acid peptic disease. Following the improved understanding of gastric secretory physiology, and the development of acid suppressants with increasing efficacy, the use of surgical intervention for peptic ulcer disease was almost eliminated. Surgery became obsolete with the dis- covery of Helicobacter pylori. Three other advances are also influencing modern practice: the gas- trotoxicity of aspirin and non-steroidal anti-inflammatory drugs is now increasingly appreciated, the role of endoscopy in the diagnosis and therapy of upper gastrointestinal bleeding, and the use of intravenous acid-suppressive agents. The major issue for the future resides within the epidemic of gastro- oesophageal reflux disease. How to diagnose, categorize and treat this condition and how to identify and prevent neoplasia, are the challenges of the new century. Aliment Pharmacol Ther 23, 683–690 Alimentary Pharmacology & Therapeutics ª 2006 The Authors 683 Journal compilation ª 2006 Blackwell Publishing Ltd doi:10.1111/j.1365-2036.2006.02817.x