[Interdigestive and postprandial duodenal pH in healthy probands, in patients with ulcer and in chronic pancreatitis].

Abstract

In patients with chronic pancreatitis (48), gastric ulcer (6), duodenal ulcer (6) and controls (12) duodenal pH was measured continuously by a glass electrode before and 90 minutes after a standard meal. The capacity of the stomach to secrete acid was known in all test persons, the degree of exocrine pancreatic insufficiency was determined according to the results of the S-CCK-test: 6 had no, 29 moderate and 13 severe pancreatic insufficiency. There were no significant differences between the mean interdigestive duodenal pH of the groups. After a meal, however, even patients with a normal pancreatic function but with hyperchlorhydria had a significantly lower pH (mean pH 5.5) than those with normo-chlorhydria (mean pH 6.1) and hypochlorhydria (mean pH 6.5). In patients with severe pancreatic insufficiency and normo-/hyperchlorhydria duodenal pH was much lower (mean pH 4.2) in some cases to pH 3.5, thus well below a level known as inactivating pancreatic enzymes. The total duration of the pH being less than 4.5 amounted to 12% of the postprandial measuring time (11 of 90 min). If, however, severe pancreatic insufficiency was combined with a-/hypochlorhydria duodenal pH did not differ from controls. Thus, reduced acid secretion of the stomach exerts beneficial effect on duodenal pH in patients with severe pancreatic insufficiency.