Hypersecretion and length of history in duodenal ulceration

Maximal gastric secretion, measured by the histamine-infusion test, was, as expected, significantly greater in a group of 81 patients with duodenal ulcer than in a group of 72 controls. After standardising for the effect of stature on maximal secretion, only 24 of the patients were found to be true hypersecretors. However, maximal secretion in the ulcer group increased with length of history of symptoms, and extrapolation back to zero length of history suggested that there was no significant hypersecretion at that time. These facts support the hypothesis that it is the presence of the ulcer that leads to hypersecretion rather than the converse. Possible mechanisms involved are chronic ingestion of antacids to counter dyspepsia, or gastric distension due to pylorospasm.