A THEORY EXPLAINING THE LOCAL MECHANISM FOR GASTRIC MOTOR AND SECRETORY CONTROL AND THE ALTERATION OF THESE FUNCTIONS IN UNCOMPLICATED DUODENAL ULCER

Abstract

In un-complicated duodenal ulcer, the abnormal gastric physiol-ogy[long dash]hypermotility, hyperperistalsis, hypertonicity, and hypersecretion[long dash]is doubtlessly responsible for most of the clinical picture. An adequate explanation for these disturbed gastric functions is lacking. It was previously shown that the normal duodenum houses a mechanism or mechanisms which are activated by the gastric HCl reaching the duodenum in adequate conc. The HCl thus acts as the intrinsic activator of local mechanisms that help to control gastric motility and also act as a self regulator of gastric secretion. In duodenal ulcer, these duodenal mechanisms are obtunded and fail to respond to the usual or normal conc. of HCl reaching them. A normal brake for gastric motor and secretory function is lost, resulting in the ab-normal gastric phenomena previously mentioned. Charts illustrate the results in normal and uncomplicated duodenal ulcer patients, upon which the theory is based. Attention is directed to the fact that food, too, may activate these duodenal mechanisms and emphasize that other mechanisms besides the local ones are concerned with gastric motor and secretory function.