Abstract
26 out of 50 patients with cholelithiasis gave evidence of gastric hyposecretion with the augmented histamine test. With the pyloric-regurgitation test, 16 out of 18 patients with cholelithiasis showed persistent reflux of dudodenal contents. Gastric hyposecretion is common in patients with gallstones, and pyloric incompetence is usual with gallstones. When gallstones form, duodenal reflux may be an associated factor that produces dysfunction and destruction of oxyntic cells. These changes are likely to cause hyposecretion, and the presence of bile and pancreatic juices in the stomach may cause the flatulent dyspepsia. If, in addition, the cardia is incompetent, heartburn may well be produced by the passage of duodenal contents, with or without gastric juices, into the œsophagus. The commonly accepted mechanism of flatulent dyspepsia is pylorospasm. In fact, the reverse appears to be the case.
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