pH-control via secretin or antacid: prophylaxia of stress ulcers in high-risk surgical patients.

The efficacy of an antacid or synthetic secretin in elevating the intragastric pH above 4 was tested in a controlled, prospective study. Twenty-one high-risk surgical patients received an antacid and 17 secretin. Antacid prophylaxis resulted in a significantly higher intragastric pH than with secretin. This was especially true in patients with several risk factors. The percent of secretin patients with a pH below 4 was higher. An increase in dosage was necessary in 4 of the 17 patients receiving secretin and in none of those receiving antacids. One stress ulcer hemorrhage occurred during secretin prophylaxis.