Abstract
To delineate stomach-pancreas interactions as related to the pathogenesis of duodenal ulcer, comparison of gastric secretory function and exocrine pancreatic function was made in controls, patients with gastric ulcer and those with duodenal ulcer. Gastric juice was aspirated before and after AOC-tetra-gastrin injection (4 jig/kg of body weight). Exocrine pancreatic function was examined by endoscopic pure pancreatic juice collection after instillation of hydrochloric acid into the duodenum (0.1 N, 100ml) ; initial HCO3 concentra-tion (wash-out phase), HCO-3 output and maximal HCO-3 concentration were evaluated. Serum secretin was also serially measured. Patients with duodenal ulcer showed significantly higher gastric acid secretion. They also showed significantly higher pancreatic HCO-3 output as well as higher initial HCO-3 concentration as was the case with our previous report on exogenous secretin stimulation. A significant correlationship was noted between gastric acid secretion and pancreatic HCO-3 secretion. However, serum secretin response showed no significant difference among the three groups. These results indicate that patients with duodenal ulcer display normal secretin release response and augmented bicarbonate secretion in response to the released secretin. Thus decreased secretin release and subsequently decreased bicarbonate secretion are unlikely causes of duodenal ulcer. Further studies are in progress with acid stimulation of more physiological ranges.
