STUDIES ON THE PATHOPHYSIOLOGY OF PEPTIC ULCER

Abstract

The role of secretin on the pathogenesis of peptic ulcer has been not fully understood. The present study was undertaken to determine secretin secretion in the peptic ulcer diseases. Studies were conducted with 30 gastric ulcer (GU) patients, 22 duodenal ulcer (DU) patients and 16 normal volunteers. Four types of the test were performed : 1) HC1 (pH 1.0, 50ml) acutely administered into the duodenum. 2) iv drip infusion of L-arginine (0.5g/kg, 30min). 3) The mean basal (BAO) and maximum gastric acid secretion (MAO) determined. 4) PFD test. Blood concentrations of secretin, gastrin, glucagon and IRI were measured by radioimmunoassay. The results obtained herein were as follows : 1) The degree of gastric acidity tended to be higher in DU than GU.2) Serum secretin response to HC1 was significantly lower in DU and normal subjects than in GU, while no change was found in serum gastrin levels.3) Both basal and arginine-induced IRI levels were lower in GU and DU than in normal controls.4) There was no difference in the fasting blood sugar, plasma glucagon and urinary catecholamine excretion between GU and DU.5) PFD test was within normal ranges in the two types of peptic ulcers.We have demonstarated a different susceptibility in secretin secretion between GU and DU following acute acidification of the duodenum. This finding suggests a possible role of secretin on the pathogenesis of peptic ulcer diseases, particularly in the hypersecretory state of gastric acid secretion which frequently characterizes DU. In addition, the present date are consistent with the current concept that there is an enteroinsular axis during development of peptic ulcer diseases.