STUDIES ON THE PATHOPHYSIOLOGY OF PEPTIC ULCER

Neutralization by Pancreatic Juice Secretion in Duodenal Lumen after Loading of HCL

Abstract

Plasma secretin concentration and bicarbonate concentration in duodenal juice were simultaneously measured in response to intraduodenal infusion of hydrocloric acid in 14 gastric ulcer patients and 26 duodenal ulcer patients. Analysis of gastric juice output was also performed on the same subjects.
The results obtained herein were as follows;
1) The mean value of BAO and MAO was significantly higher in douodenal ulcer patients than that of gastric ulcer patients (p<0.01).
2) The mean value of total bicarbonate output was lower in duodenal ulcer patients than that of gastric ulcer patients, although the difference was not significant.
3) The total bicarbonate output/MAO ratio was significantly lower in duodenal ulcer patients than that of gastric ulcer patients (p<0.01).
4) A significant correlation between the total bicarbonate output and amylase output was observed in all peptic ulcer patients (p<0.005).
5) The peak increment of secretin value (peak secretin value-basal secretin value) and total bicarbonate output was significantly correlated in gastric ulcer patients (p<0.05), but not in duodenal ulcer patients.
6) The plasma secretin response in duodenal ulcer patients was similar to that of gastric ulcer patients.
These data suggest that there is an impairment in the mechanism by secretin of pancreatic juice secretion in some of the patients with duodenal ulcer.