The Accurate assessment of maximal gastric secretion in control subjects and patients with duodenal ulcer

Abstract

Abstract Maximal gastric secretion was studied in 34 control subjects and 29 patients with duodenal ulcer using the histamine-infusion test with the addition of an inert marker, phenol red, to correct for pyloric losses of gastric secretion. In the control group, statistically significant correlations were found between maximal gastric secretion and almost all the indices of body stature. Correction for pyloric loss improved all the correlations and raised those correlation coefficients which were not significant to levels of confidence of 95 percent or more. The validity of calculation of lean body mass from height and weight was checked by the estimation of total body potassium in 26 subjects. When lean body mass was taken into account it was confirmed that maximal gastric secretion decreased with age, but the sex difference in maximal gastric secretion was no longer statistically significant. In the duodenal ulcer group, maximal gastric secretion was also significantly correlated with stature, though not with age. It is, therefore, proposed that stature should be taken into account when defining hypersecretion. As expected, patients with duodenal ulcer produced as a group significantly higher levels of maximal gastric secretion than did control subjects, but the effect appeared to be due to a minority of patients with hypersecretion. Patients with a history of less than 4 years secreted proportionately less gastric juice than those with a longer history. This finding raises the possibility that gastric hypersecretion is a result of duodenal ulceration rather than a cause.