Effect of intravenous calcium administration on gastric secretion of acid and pepsin in man.

Despite reports of the association of hyperparathyroidism and peptic ulcer (Rogers, Keating, Morlock, and Barker, 1947; Black, 1953; Hellstr6m, 1959), the relationship cannot be accepted as proven (Ostrow, Blanshard, and Gray, 1960). The issue is clouded by the differing figures given for the incidence of peptic ulcer in the community (Ivy, Grossman, and Bachrach, 1950; Jones, 1959; Ellison, Abrams, and Smith, 1959), the common occurrence of dyspeptic symptoms in patients with hyperparathyroidism who have no ulcer (Gutman, Swenson, and Parsons, 1934; St. Goar, 1957), and the association of parathyroid and pancreatic adenomas, where peptic ulceration may be related to the latter. This apparent association between hyperparathyroidism and peptic ulcer raises the question of a possible relationship between serum calcium levels and gastric function. Previous studies on the effects of parathyroidectomy on gastric secretion in patients with hyperparathyroidism have produced conflicting results (Donegan and Spiro, 1960; Ward, Adesola, and Welbourn, 1964; Barreras and Donaldson, 1966). Hypercalcaemia produced by intravenous calcium administration in humans has been found, with one exception (Fikry and Dorry, 1964), to lead to an increase in gastric secretion (Donegan and Spiro, 1960; Barreras and Donaldson, 1966; Sereghy and Gyurkovich, 1927; Ottenjann. Widmaier, and Demling, 1963; Fillastre, Blaise, Bernier, and Richet, 1963; Murphy, Goldstein, Boyle, and Ward, 1966). However, a detailed examination of the pattern of rise and fall of serum calcium and gastric secretion has not been made. The demonstration of a parallel relationship between the serum calcium and gastric secretion would be an essential prerequisite for the application of the findings in these acute experiments to the clinical situation. This study was undertaken to clarify the relationship between serum calcium levels and gastric secretion following intravenous calcium, and to investigate the mechanism whereby intravenous calcium produced its apparent secretagogue effect.