Document Detail


Impaired proximal duodenal mucosal bicarbonate secretion in patients with duodenal ulcer.
MedLine Citation:
PMID:  3807974     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The defensive factors that prevent the human duodenal mucosa from acidic and peptic damage have not been fully evaluated. To determine whether duodenal mucosal bicarbonate production was altered in patients with inactive duodenal ulcer, we measured basal and acid-stimulated bicarbonate output from the duodenal bulb and the distal duodenum in healthy subjects and patients with inactive duodenal ulcer. As compared with 16 normal subjects, the 12 patients had significantly less mean (+/- SE) basal proximal duodenal mucosal bicarbonate secretion (185 +/- 13 vs. 107 +/- 18 mumol per centimeter per hour; P less than 0.001). Moreover, in response to a physiologic amount of hydrochloric acid (2 mmol per five minutes) instilled directly into the duodenal bulb, peak proximal duodenal bicarbonate output in the patients was 41 percent of the normal response (263 +/- 65 vs. 642 +/- 77 mumol per centimeter per hour; P less than 0.01). There was little overlap between groups. In contrast, bicarbonate outputs in the distal duodenum were similar in the two groups. We conclude that most patients with duodenal ulcer disease have decreased proximal duodenal mucosal bicarbonate production at rest, in response to hydrochloric acid, and in relation to peak gastric acid secretion. Impaired proximal duodenal mucosal bicarbonate secretion may be an important factor in the development and natural history of duodenal ulcer.
Authors:
J I Isenberg; J A Selling; D L Hogan; M A Koss
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The New England journal of medicine     Volume:  316     ISSN:  0028-4793     ISO Abbreviation:  N. Engl. J. Med.     Publication Date:  1987 Feb 
Date Detail:
Created Date:  1987-03-06     Completed Date:  1987-03-06     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0255562     Medline TA:  N Engl J Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  374-9     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Bicarbonates / secretion*
Duodenal Ulcer / physiopathology*
Duodenum / secretion*
Female
Humans
Hydrochloric Acid / diagnostic use
Intestinal Mucosa / secretion
Male
Middle Aged
Grant Support
ID/Acronym/Agency:
AM 07202/AM/NIADDK NIH HHS; AM 33491-02/AM/NIADDK NIH HHS
Chemical
Reg. No./Substance:
0/Bicarbonates; 7647-01-0/Hydrochloric Acid

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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