We have described a present view of origin and development of gastric carcinoids as well as a tase report of a 69-years old man with gastric carcinoid. The patient underwent an endoscopic investigation before a planned anticoagulation therapy. During this investigation a gastric polyp was diagnosed and endoscopic polypectomy was performed. Histological tests confirmed a gastric carcinoid. A severe atrophic gastritis with other two minor carcinoids and hypergastrinaemia were diagnosed during an examination at a specialized department. Recommended procedures as gastrectomy or antrectomy (lowering the serum gastrin level) were contraindicated because of serious complications and polymorbidity. A substitutional therapy with HCl-pepsin (-- mixture hydrochloric acid plus pepsim) was suggested. After this medication patient's appetite improved and dyspeptic complaints slightly disappeared. After a 6-month treatment with hydrochloric acid substitution all carcinoids regressed and no new one has developed. Decrease of serum gastrin level was only temporary. Therefore it is important to check patient's serum gastrin level regularly and to perform endoscopy in the next period. For carcinoid regression the presence of hydrochloric acid in the stomach seems to be more important then the decrease of plasma gastrin level.

        Key words: gastric carcinoid, achlorhydria, hypergastrinaemia, hydrochloric acid substitution, regression