Serum cholecystokinin, basal acid secretion, and infantile pyloric stenosis.

Abstract

SUMMARY The fasting serum cholecystokinin-like activity was measured in 21 infants with pyloric stenosis and in 13 normal controls. No significant difference was found between the two groups. The basal acid secretion was measured by continuously aspirating the previously emptied stomach for one hour. The basal gastric volume and the total and the free acidity were all greater in the pyloric group.

The true cause of pyloric stenosis is hyperacidity

“…Most significantly, the high acid secretion rates persist after pyloromyotomy. They have repeated the proposal that PS is caused by an inherited supernormal parietal cell mass 10,2122. Long‐term studies have also revealed that high acid secretion persists after surgical treatment 23.…”

“…Acid secretory rates in PS are far higher than in normal babies, both in volume and in acid secretion 21. Indeed, it is only in babies with PS that free acid can be measured at all despite the aspirate still being heavily milk‐stained despite initial aspiration 21.…”

The enigma of pyloric stenosis. Some thoughts on the aetiology

“…Despite the frequently milky nature of the aspirate, fasting gastric acid secretion is significantly greater in the baby with PS as compared with age-matched controls in terms of pH, free acid and total acidity (15,20). Age In Weeks Fig.…”

The Cause of Pyloric Stenosis of Infancy: Primary Hyperacidity and Biochemistry Combined

“…Basal acid secretion measured by titration rather than pH shows that babies with PS are huge hypersecretors of acid despite there being no significant difference in the fasting pH. 24 Indeed, when tested by histamine stimulation 1 week after successful pyloromyotomy, babies with PS still demonstrated hyperacidity at a time when pyloric obstruction was no longer present. 25 Babies with PS suffer more often in later life from the complications of hyperacidity, for example, Duodenal/peptic ulcer surgery.…”