Gastrointestinal Tract in Hyperthyroidism before and after Treatment

Abstract

The state of the upper gastro-intestinal tract in hyperthyroidism was studied in 42 patients before and after treatment. Gastritis was found in 30 patients out of 39. The incidence of gastritis in the control series was 52 per cent. Numerous plasma cells and aggregates of lymphocytes were commonly observed in both gastric and intestinal biopsy specimens. Before treatment the basal secretion of hydrochloric acid was 1.2 mEq/h and after histalog stimulation 4.6 mEq/h. There was usually a fairly good correlation between the secretion values and the gastric morphology, but in 5 patients the maximal stimulation values remained below 1 mEq/h, in spite of a normal or only slightly altered gastric mucosa. The re-examination, performed 4 months after treatment, revealed improvement of gastritis in 7 and progress in 2 of 21 patients. In the 16 patients examined, the average number of eosinophils in gastric mucosa increased from 33 to 47 per 0.1 mm² of tissue. The hydrochloric acid secretion revealed a decreasing trend, in particular in patients who initially had values above 5 mEq/h. In 3 patients with initial values below 5 mEq/h a distinct increase was observed. Faecal fat excretion was definitely increased in 7 out of 30 hyperthyroid patients, in spite of a normal villous structure. Five patients were re-examined after adequate treatment and the fat excretion had returned to normal in all instances.