Basal gastric secretion: reproducibility and relationship with duodenal ulceration

Basal gastric secretion was examined in control subjects, patients with duodenal ulcer, and patients after vagotomy with or without a drainage procedure, not only in terms of conventional indices of secretion--volume, titratable aciditiy, and acid output--but also in terms of the volume corrected for pyloric losses and duodenal reflux (Vg). In all groups, secretion was less in the second than in the first half-hour of a one-hour basal collection. Basal secretion was examined on more than one occasion in non-operated subjects and patients after vagotomy with or without a drainage procedure. In both groups extreme variability in secretion was found from one study to the next, and the variability was the same whether secretion was expressed in terms of conventional indices or VG. It is concluded that such variability is physiological rather than due to experimental errors. Basal secretion was found on average to be greater in duodenal ulcer patients than in control subjects, and, after vagotomy, to be greater in patients with recurrent ulcer than in asymptomatic patients. However, despite all the corrections made, the overlap in the results from the different groups was so great that basal secretion could not be ascribed an aetiological role in the majority of patients with duodenal ulcer.