Five patients (four with vitiligo and one with pernicious anaemia) were subjected to the histamine infusion test; there were achlorhydric while the remaining two secreted quite small amounts of acid. [Na+],[Cl-)and[alkali]were determined in the alkaline gastric juice samples (pH greater than 7.0). In order to assess the contribution of swallowed saliva the histamine test was done twice in each patient: (A) with precautions to prevent swallowing of saliva; and (B) with the patient allowed to swallow saliva freely. In each sample reflux of duodenal juice was estimated so that its contribution to the alkaline gastric aspirate could be assessed. Such reflex was absent in one patient, negligible in another, while in the remaining three patients the mean pyloric reflux amounted to no more than 8% of the observed volume. Swallowed saliva had diluting effect on [Na+] and [Cl-] but raised K+ concentration in the alkaline gastric aspirate. The comparison of alkaline gastric juice, free to an appreciable extent of salivary contamination, was shown to be relatively constant. The results are consistent with the two-component hypothesis of gastric secretion.
Using a method that involves corrections for pyloric losses and duodenogastric reflux, we determined gastric acid secretion in 36 control subjects (25 males and 11 females) and 58 patients with duodenal ulcer (44 males and 14 females). Most of the study subjects were Saudis, except for nine Yemenis. Mean basal and pentagastrin-stimulated or maximal acid outputs in male controls were 1.78 ± 1.49 (SD) and 19.86 ± 7.91 mmol/h, respectively; in female controls the corresponding values were 1.76 ± 2.02 and 16.23 ± 4.33 mmol/h, with maximal secretion positively correlating with height, weight, and lean body mass (LBM), and negatively with age. In the duodenal ulcer group, mean basal and maximal acid outputs for men were 3.81 ± 3.42 and 27.08 ± 9.54 mmol/h and for women, 1.55 ± 2.37 and 18.60 ± 7.53 mmol/h. Maximal acid secretion correlated positively with height, weight, LBM, and duration of illness. In male patients with duodenal ulcer, mean basal and stimulated acid secretion were significantly higher than in the male controls, the proportion of hypersecretors being 20.45%. In women the differences were of borderline significance. Men secreted more acid than women, and when maximal secretion was standardized for height, this sex difference disappeared. Height standardization did not affect the differences in acid secretion between patients with duodenal ulcer and controls. Our results confirmed the well-known association of blood group O with duodenal ulcer and revealed a significant association of this disease with family history of peptic ulcer. The
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