Comparison of intraduodenal and intravenous administration of amino acids on gastric secretion in healthy subjects and patients with duodenal ulcer

• Published in: Gut 1978-10, Vol.19 (10), p.859-864
• Main Authors: Konturek, S J, Kwiecień, N, Obtułowicz, W, Mikoś, E, Sito, E, Oleksy, J
• Format: Article
• Language: English
• Subjects: Adult; Amino Acids - administration & dosage; Amino Acids - pharmacology; Cimetidine - pharmacology; Duodenal Ulcer - physiopathology; Duodenum; Gastric Juice - metabolism; Humans; Infusions, Parenteral; Male; Pentagastrin - pharmacology; Pepsin A - metabolism; Secretory Rate - drug effects; Stimulation, Chemical
• ISSN: 0017-5749; 1468-3288; 1458-3288
• DOI: 10.1136/gut.19.10.859

The ability of an amino acid mixture given intraduodenally or intravenously to stimulate gastric secretion is compared in healthy subjects and in duodenal ulcer patients. Graded amounts of amino acids by both routes produced a similar increase in acid output in healthy subjects, reaching about 30% of the maximal response to pentagastrin. Serum gastrin concentrations remained virtually unchanged but serum alpha amino acid nitrogen levels were about twice as high with intravenous as with intraduodenal administration. Intravenously administered amino acids produced a significantly higher acid output in patients with duodenal ulcer than in healthy subjects, but did not produce a significant increase in gastric acid or pepsin secretion when combined with a pentagastrin infusion as compared with pentagastrin alone. Cimetidine (2 mg/kg/h) added to intravenous amino acid infusions caused almost complete suppression of acid secretion. This study indicates that amino acids are capable of stimulating gastric secretion after intraduodenal and after intravenous administration. The response to the latter is significantly higher in patients with duodenal ulcer than in healthy subjects, does not appear to involve gastrin release, is not affected by pentagastrin, and is strongly suppressed by histamine H2-blocker.