Site of peptic ulcer. comparison of hydrochloric acid output, pepsinogen and gastrin serum levels.

BACKGROUND/AIMS: Basal (BAO) and maximum (PAO) hydrochloric acid output after Histalog stimulation, basal pepsinogen (SPL-B), at 60 (SPL-60) and at 90 minutes (SPL-90), and basal gastrin (BG) levels were measured and compared in different gastric (GU) and duodenal (DU) ulcer sites. MATERIAL AND METHODS: Fifty nine patients with peptic ulcer were grouped according to Johnson's classification for gastric ulcers: type I (15), type II (16) type III (12) GU and (16) DU. Fifteen normal subjects were studied as controls. RESULTS: The BAO was greater in the DU than in the control or GU groups. No significant difference was noted in the production of hydrochloric acid after stimulation with Histalog. The SPL-B, at 60 and at 90 minutes was higher in type II GU than in the DU group and controls. The SPL-60 was higher in type II GU patients than in type III GU. Basal gastrin was higher in group DU and types II and III GU compared to the type I GU patients and controls. CONCLUSION: The topographic criteria for differentiating peptic ulcers has low discrimination capacity based on comparison of mean values of HCl acid production, pepsinogen and gastrin serum levels both basal and after stimulation with Histalog due to heterogeneity of these variables in group studies. In these studies, peptic ulcers from different sites should not be grouped as distinct entities except for type II gastric ulcers.

Identification of heterogenous motility patterns of the stomach in duodenal ulcer disease.

This study aims to compare gastric emptying of solid meals in two different duodenal ulcer populations and their respective control groups. The same authors, utilized the same methods, but on different occasions. Four study groups were composed as follow: DU I--15 patients, CI--12 patients, DU II--16 patients, C II--15 patients. All individuals underwent high gastrointestinal tract evaluation. Endoscopy was normal in all subjects of the control groups. The ulcers were active but without reducing of the duodenal lumen. Gastric emptying was studied with the use of 30 grams of Tc tagged chicken liver. Measurements of Gastric emptying were taken by a gamma camera Ohio-series ON-150) with 15 minutes intervals during 120 minutes. Emptying rates expressed as percent of the test meal remaining in the stomach were submitted to KRUSKAL-WALLIS STATISTICAL analysis at each time and were identical in the groups, DU I, C I and C II. Emptying rates were significantly lower in the DU II group compared to the others. This study permits us to conclude that the gastric emptying in duodenal ulceration can be normal or delayed for reasons not clearly understood.