Intragastric bile acid and lysolecithin in gastroduodenal ulcer and gastric cancer

In 99 patients with different types of gastroduodenal ulcer and gastric carcinoma the intragastric concentrations of bile acids and lysolecithin was analyzed under fasting, basal and pentagastrin-stimulated conditions. Normal concentrations were found in type III gastric ulcer (prepyloric). There was a three- to four fold increased reflux concentration in the mean of patients with gastric ulcer type I but some patients showed normal values too. The calculated reflux rate was also slightly elevated. In duodenal ulcer normal concentrations could be observed with the exception of a slight increase under fasting conditions. In gastric carcinoma of the proximal half normal reflux concentrations were found. Distal gastric carcinoma was associated with a two- to three-fold increase of bile acids as well as lysolecithin concentration. The same was found concerning the reflux rate. Our results demonstrated a comparable low increase of duodenogastric reflux concentration in proximal gastric ulcer and distal gastric carcinoma. They give no evidence for a major role of reflux in the pathogenesis of gastroduodenal ulcer.