Abstract
Gastroduodenal mucosal surface pH was measuredin situ by electrode in endoscopically normal and gastric ulcer patients. With the exception of the antrum, mucosal surface pH in the ulcer group (GU) resembled that of the endoscopically normal group. In contrast, the antral mucosal surface pH of the GU group of 7.06±0.11 (22) was significantly (P<0.001) higher than that of 5.46±0.36 (34) for the endoscopically normal group. This difference was also evident when comparison was restricted to subjects in both groups having a fundal luminal fluid pH of less than 3. When the fundal luminal pH was below pH 3, antral mucosal surface pH was 4.79±0.41 (24) in endoscopically normal subjects and significantly less (P<0.001) than the value of 6.98±0.18 (12) for gastric ulcer patients. Mucosal surface alkalinity of the GU antrum may be a response to damage but seems inappropriate in view of the likelihood of acid dependent inhibition of gastric acid secretion.
Similar content being viewed by others
References
Allen A, Garner A: Mucus and bicarbonate secretion in the stomach and their possible role in mucosal protection. Gut 21:249–262, 1980
Rees WDW, Turnberg LA: Mechanism of gastric mucosal protection: A role for the “mucus-bicarbonate” barrier. Clin Sci 62:343–348, 1982
Flemström G, Turnberg LA: Gastroduodenal defence mechanisms. Clin Gastroenterol 13:327–354, 1984
Ross IN, Bahari HMM, Turnberg LA: The pH gradient across mucus adherent to rat fundic mucosa in vivo and the effect of potential damaging agents. Gastroenterology 81:713–718, 1981
Kivilaakso E, Flemström G: Surface pH gradient in gastroduodenal mucosa. Scand J Gastroenterol 19(suppl92):50–52, 1984
Bahari HMM, Ross IN, Turnberg LA: Demonstration of a pH gradient across the mucus layer on the surface of human gastric mucosain vitro. Gut 23:513–516, 1982
Flemstrom G, Garner A: Gastroduodenal HCO −3 transport: characteristics and proposed role in acidity regulation and mucosal protection. Am J Physiol 242:G183-G193, 1982
Guerre J, Gaudric M, Bars L, Nepveux A, Cornuau J, Lemaigre G: Mesure du pH oeso-gastro-duodenal pendant l'endoscopie chez l'homme. A propos de 217 examens. Gastroenterol Clin Biol 5:37–41, 1981
Vicari F, Marliere Ph, Jacquier A, Laurent J, Jeanpierre R, Watrin B, Duprez A: L'apport de la pH-metrie per-et trans-endoscopique dans l'exploration du tractus digestif haut. Nouv Presse Med 11:1063–1066, 1982
Rawlings JM, Danesh BJZ, Farah D, Main ANH, Morgan RJ, Murray W, Lucas ML, Russell RI: Duodenal loop alkalinisation in DU: Stimulus or response? Gut 25:A1139, 1984
Danesh BJZ, Rawlings JM, Lucas ML, Russell RI: Duodenal ability to produce an alkaline microclimate and its relation to gastric acid secretion in patients with duodenal ulcer disease. Gastroenterology 92:A1361, 1987
Danesh BJZ, Stark O, Lucas ML, Rawlings JM, Russell RI: Capacity of the duodenal neutral pH-barrier to withstand acid challenge in health and disease. Gastroenterology 92:1362, 1987
Danesh BJZ, Stark O, Rawlings JM, Lucas ML, Russell RI: Ability of duodenum to maintain a neutral pH-microclimate in response to acid challenge in endoscopically normal and duodenal ulcer subjects. Gut 28:A1405, 1987
Quigley EMM, Turnberg LA: pH of the microclimate lining human gastric and duodenal mucosain vivo. Gastroenterology 92:1876–1884, 1987
Rovelstad RA, Owen CA, Magath TB: Factors influencing the continuous recording ofin situ pH of gastric and duodenal contents. Gastroenterology 20:609–624, 1952
Andersson S, Grossman MI: Profile of pH, pressure and potential difference at gastroduodenal junction in man. Gastroenterology 49:364–371, 1965
Lucas ML: pH or hydrogen-ion concentration in statistics? Lancet 2:826, 1977
Dixon WJ, Brown MB, Engelman L, Frane JW, Hill MA, Jennrich RI, Toporek JD (eds): BMDP Statistical Software. University of California Press, Berkeley, 1981
Bickel M, Kauffman GL: Gastric gel mucus thickness: Effect of distension, 16,16-dimethyl prostaglandin E2, and carbenoxolone. Gastroenterology 80:770–775, 1981
Diamond J: A rapid method for determining voltage concentration relations across membranes. J Physiol 183:83–100, 1966
Sernka TJ, Jackson AF: Hyperosmotic instillation of rat stomach. Life Sci 17:435–442, 1975
Read NW, Fordtran, JS: The role of intraluminal junction potentials in the generation of gastric potential difference in man. Gastroenterology 76:932–938, 1979
Hojgaard L, Andersen JR, Krag E: A new method for measurement of the electrical potential difference across the stomach wall. Scand J Gastroenterol 22:847–858, 1987
Guslandi M, Ballarin E: Assessment of the ‘mucusbicarbonate’ barrier in the stomach of patients with chronic gastric disorders. Clin Chim Acta 144:133–136, 1984
Capper W, Laidlaw CD'A, Buckler K, Richards D: The pH fields of the gastric mucosa. Lancet 2:1200–1202, 1962
Capper WM, Butler TJ, Buckler KG, Hallett CP: Variation in size of the gastric antrum: Measurement of alkaline area associated with ulceration and pyloric stenosis. Ann Surg 163:281–290, 1966
Hawkey CJ: Synthesis of prostaglandin E2, thromboxane B2 and prostaglandin catabolism in gastritis and gastric ulcer. Gut 27:1484–1492, 1986
Garner A, Flemström G: Gastric HCO −3 secretion in the guinea pig. Am J Physiol 234:E535-E541, 1978
Andersen LP, Holck S, Povlsen CO, Elsborg L, Justesen T:Campylobacter pyloridis in peptic ulcer disease. Scand J Gastroenterol 22:219–224, 1987
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Rawlings, J.W., Danesh, B.J.Z., Lucas, M.L. et al. Gastroduodenal mucosal surface and luminal pH in gastric ulcer. Digest Dis Sci 36, 1543–1549 (1991). https://doi.org/10.1007/BF01296395
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01296395