Although the cause of Brunner’s gland hamartomas is unknown, interesting associations have been noted. Because these glands function to buffer the acid output of the stomach, it has been postulated that Brunner’s gland hyperplasia (and, by extension, Brunner’s gland hamartomas) may be due to hyperchlorhydria. Although this theory may seem plausible, gastric hyperacidity itself is thought to be an unlikely cause, given that Brunner’s gland hyperplasia is not seen in patients with Zollinger-Ellison syndrome. In addition, Spellberg and Vucelic noted that these lesions did not regress after short term cimetidine therapy. Furthermore, Kaplan and colleagues demonstrated, in 1968, that a majority of patients with documented Brunner’s gland hyperplasia did not have increased gastric acid output. Interestingly, Tottrup, et al questioned whether hyperplasia of Brunner’s glands might actually lead to gastric hyperacidity (and not the other way around). They noted that hyperplasia of these glands is associated with subsequent proliferation of duodenal gastrin cells; this may lead to increased gastrin secretion and, consequently, an increase in gastric acid output. High quality medications available at best pharmacy that will make sure you are comfortable and secure when buying cialis professional or any other medicine that you need at any point.