Physiological abnormalities in duodenal ulcer: A brief review

Abstract

Patients with duodenal ulcer may have one or more of the following abnormalities: 1. (1) larger than normal volume of gastric mucosa containing correspondingly more acid and pepsin secreting cells which is reflected in 2. (2) increased mean concentration of pepsinogen-I in plasma, and 3. (3) increased maximal rates of secretion of acid and pepsin in response to stimuli such as histamine, gastrin, insulin, or food; 4. (4) increased sensitivy to stimulation by gastrin as reflected by decreased dose of gastrin needed to evoke half maximal response; 5. (5) increased gastrin response to meals; 6. (6) decreased inhibition of gastrin release and of acid secretion in response to acidification of the gastric contents; and 7. (7) increased rapidity of gastric emptying. Items 2, 5, and 7 are heritable autosomal dominant traits in at least some patients. Although mean values of each of these 7 items are significantly different from normal, the range is wide and most individual duodenal ulcer patients fall within the normal range. The diversity of physiological abnormalities found in patients with duodenal ulcer shows that it is a heterogeneous disease with many different factors operating in its pathogenesis.