Impaired neutralizing capacity of duodenal mucosa following luminal acidification in recurrent duodenal ulcer.

To investigate the role of the mucus-bicarbonate barrier in the prevention of duodenal ulcer recurrence, duodenal mucosal neutralizing capacity and mucosal prostaglandin (PG) synthesis were examined in 5 normal controls (NC) and 12 duodenal ulcer (DU) patients. DU patients were divided into non-recurrent (NR,7) and recurrent (R,5) groups based on endoscopic follow-up study. The recovery time (RT) was significantly longer and the mucosal PGE2 synthesis was significantly lower in R than in NC and NR groups. There was a proportional correlation between mucosal PG synthesis and RT in DU These results indicate that impaired neutralizing capacity caused by reduced endogenous PG synthesis in duodenal mucosa may contribute to recurrence of DU.