Abstract
Summary The back diffusion of hydrogen ion into the normal and abnormal human gastric mucosa was determined by (1) comparing the acid secretion of the stimulated mucosa with and without a glycine buffer solution in the stomach, and (2) measuring hydrogen, sodium, potassium, and chloride fluxes following the instillation of an acid solution into the stomach. The glycine buffer detected more acid secretion in almost all patients. The increase seen when comparing the normal with the abnormal gastric mucosa was proportionally similar. It appears that back diffusion from the stomach lumen proper does not occur during active secretion in patients with gastric ulcer, gastritis, and hyposecretion; however, back diffusion could be occurring elsewhere along the secretory pathway. A significant net back diffusion of hydrogen ion into the mucosa was noted following the instillation of an acid solution into the stomach of patients with gastric ulcer, gastritis, or hypochlorhydria. An apparent increase in sodium content in the gastric lumen was likewise found. These changes are similar to those found in experimental damage to the canine stomach. We conclude that an abnormally permeable human gastric mucosa exists and that hydrogen ion diffusion into gastric mucosa occurs and may be injurious to the human stomach.
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