Duodeno-gastric reflux in gastric ulcer patients in relation to intestinal metaplasia of the gastric mucosa.

Using vitamin B12 labelled with Co58 as an exogenous marker, and bilirubin as an endogenous marker, the duodeno-gastric reflux was determined quantitatively in 13 gastric ulcer patients under basal conditions and under stimulation (1 CU secretin/kg body weight + 1 CU pancreozymin/kg body weight) of the exocrine pancreas; in addition, a histological examination of the gastric mucosa was carried out by taking multiple biopsies from along the greater and lesser curvatures of the stomach. Altogether, a more marked mean duodeno-gastric reflux was found in the ulcer patients than in the 14 control subjects. If, however, the ulcer patients are differentiated in accordance with the results of the histological findings in the biopsy material, it is seen that an increased reflux is found only in those ulcer patients presenting with an intestinal metaplasia in the antrum. Statistically, no increase in the duodeno-gastric reflux can be verified under secretin/pancreozymin stimulation of the pancreas.