Abstract

(1) Twenty-one synchronous gastro-duodenal motility studies are presented on four patients with duodenal ulcer, in all approximately 75 hours of actual synchronous motility recordings. The dual balloon kymograph bromoform manometer method was employed. The patients recorded ulcer distress on the kymograph by means of an electric signalling device. (2) The four phases of synchronous gastro-duo-denal motility previously found to exist in the normal subject was also found to exist in the patients with duodenal ulcer. (3) Ulcer distress, experienced by the patients during the course of these studies, was recorded by them only during periods when the duodenum was in an active state of motility regardless of the state of the gastric phase. The stomach was either in quiescence or in activity when ulcer distress was recorded. (4) When the ulcer patients experiencedsevere epigastric (ulcer) pains of relatively long duration (15-18 minutes or longer) there was a definite abnormality in the duodenal activity. The duodenum passed into a state of increased tonus simulating a condition of incomplete tetanus. (5) While it was found that gastric motility may at times augment duodenal activity, it was also found that the duodenum at times initiates a period of activity when the stomach is in a quiescent state. This would appear to indicate that the duodenum possesses autonomy of action, and its period of activity and quiescence may be entirely independent of the stomach.

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