Cortisol excretion into gastric juice. Studies in health, in digestive ulcer disease, and in surgery stress.

Gastric juice cortisol concentrations in 36 healthy subjects in the basal state was 10.5 +/- 2.1 ng/ml. After stimulation with pentagastrin it was 11.5 +/- 3.2 ng/ml. There were no differences related to age or sex. Cortisol outputs were 25.9 +/- 12.1 ng/min in the basal state and 35.9 +/- 13.2 during pentagastrin stimulation. After stimulation with ACTH in 6 subjects gastric juice cortisol concentration increased 5.4 times while gastric cortisol output increased 19-fold. The plasma cortisol rose by a factor of 2.3 while the plasma free cortisol rose by a factor of 2.6. Gastric juice cortisol concentration increases correlated with concentrations of free and total plasma cortisol in plasma. When plasma levels of cortisol or dexamethasone were raised by intravenous infusions, the concentration in gastric juice depended on the free corticoid concentration in plasma. Gastric juice cortisol concentrations in 38 patients with gastric, duodenal, or combined gastric and duodenal ulcers were the same as in normal subjects. In 6 patients studied up to 6 days following abdominal surgery, both plasma and gastric cortisol concentrations were elevated but the increase in gastric juice cortisol was proportionally greater. This was not due to vagal stimulation, as shown by the failure of gastric juice cortisol concentrations to rise similarly during insulin hypoglycemia. Postsurgical increases in gastric juice cortisol may reflect the loss of protein-bound cortisol into the gastrointestinal tract as a result of injury to the gastric mucosa.