Gut Hormone Release by Intraduodenal Stimulation in Duodenal Ulcer Patients

Abstract

After an overnight fast, plasma levels of gut peptide hormones were determined before and after intraduodenal stimulation (IDS) with glucose and citric acid in 8 patients with a recent endoscopically proved duodenal ulcer (DU) attack and in 8 healthy volunteers. The DU patients had a hyperacidic mean BAO of 6.6 and an average PAO of 41.8 mEq/h. In DU, basal secretin levels were similar to those in controls, and after IDS secretin release was not impaired. There was no defect of VIP liberation or of the neurotensin response (basal 21 ± 7 vs 16 ± 3, after IDS 68 ± 28 vs 35 ± 5 pmol/1) which could account for gastric acid hypersecretion. Although fasting GIP levels were significantly lower than in controls (16 ± 2.5 vs 25 ± 1.4 pmol/1), they did not correlate negatively with BAO. In contrast to former studies with oral test meals, integrated GIP release was rather reduced after IDS. Basal plasma levels of gastrin were significantly lower in DU (4.0 ± 0.4 vs 12 ± 2 pmol/1) and were inversely related to BAO (r = - 0.82, p < 0.02). From the present data, there is insufficient evidence for abnormal plasma levels of gut hormones as major etiologic factors for basal hyper-chlorhydria in ordinary DU disease.

Key Words:

• Basal acid secretion
• duodenal ulcer
• gastric inhibitory peptide
• gastrin
• motilin
• neurotensin
• secretin
• vasoactive intestinal peptide