Factors concerned in determining the chronicity of ulcers in the stomach and upper intestine: 1. Susceptibility of jejunum to ulcer formation 2. Effect of diet on healing of acute gastric ulcer

Abstract

The following factors as determinants of chronicity of ulcer of the stomach and upper intestines have been discussed: (1) infection, (2) mechanical effect of food and motility, (3) blood flow and fibroblastic reaction, (4) allergy, (5) nutrition or digestive disturbance, (6) corrosive or irritating action of gastric contents, and (7) mucosal susceptibility. Experimental evidence is cited which shows that the roughage in or consistency of the diet in the presence of a factor conducive to connective tissue proliferation is conducive to the formation of a chronic gastric ulcer in rabbits. Experiments have been devised in an attempt to evaluate the mechanical, nutritional, chemical and mucosal susceptibility factors in the etiology of intestinal ulcers following gastroenterostomy. The evidence shows that all these factors operate and that the mechanical, chemical and mucosal susceptibility factors are the most important. On keeping the mechanical factor constant and varying the chemical factor (the change in the chemical factor leads to some change in nutrition, which could not be avoided in all animals), it is shown that the chemical factor is the most important. On keeping the nutritional factor constant and by analyzing the chemical, mechanical and mucosal susceptibility factors, it is shown that the jeJunaI mucosa is more sensitive to the irritating action of gastric contents than duodenal mucosa.