Duodenal pH values in normal controls and in patients with duodenal ulcer1

Recent studies by Wormsley and Mahony (1967) and by Banks, Dyck, Dreiling, and Janowitz (1967) have shown that the ratio between the secretory capacity of pancreatic bicarbonate and gastric acid is lower in duodenal ulcer patients than in normal subjects. It has therefore been suggested (Wormsley and Mahony, 1967; Rovelstad, 1956) that duodenal neutralization is insufficient in this disease. Some studies have supported this theory by demonstrating higher duodenal pH values in normal controls than in subjects with duodenal ulcer (Kearney, Lomfort, and Osterberg, 1941; Atkinson and Henley, 1955; Archambault, Rovelstad, and Carlson, 1967). Other studies, however, have not been able to show such a difference (Rhodes and Prestwich, 1966) and this question can still be considered open. The present study investigates this problem further by measuring fasting and postprandial duodenal pH values in normal and ulcer subjects. By selecting the cases so that the two groups did not differ with respect to gastric secretory capacity, a possible difference due to the gastric hypersecretion usually associated with duodenal ulcer could be eliminated.