A SUBSTANTIAL PROPORTION OF NONULCER DYSPEPSIA PATIENTS HAVE THE SAMEABNORMALITY OF ACID-SECRETION AS DUODENAL-ULCER PATIENTS

Acid secretion in response to gastrin releasing peptide (GRP) is incre ased sixfold in Helicobacter pylori positive duodenal ulcer (DU) patie nts and threefold in H pylori positive healthy volunteers, and this fu lly resolves after eradication of the infection. This study was undert aken to determine whether a proportion of H pylori positive patients w ith non-ulcer dyspepsia (NUD) have an acid secretion disturbance simil ar to DU patients. Basal and GRP stimulated gastrin concentrations and acid output were examined in 25 H pylori positive NUD patients and th e results compared with those of 25 H pylori positive healthy voluntee rs, 25 H pylori negative healthy volunteers, and 25 H pylori positive DU patients. Compared with the H pylori negative healthy volunteers, G RP stimulated gastrin was increased approximately three fold in each o f the three infected groups. GRP stimulated acid secretion (median, ra nge) was higher in the H pylori positive NUD patients (29.6 mmol/h (5. 2-46.5)) (p<0.005) than in the H pylori positive healthy volunteers (1 9.0 (1.0-38.3)) (p<0.001) or H pylori negative healthy volunteers (6.3 (2.8-20.9)) (p<0.0001). The H pylori positive NUD patients, however, had lower acid output than the DU patients (39.1 (17.9-64)) (p<0.005), These findings are consistent with approximately 50% of the NUD patie nts having a similar disturbance of GRP stimulated acid secretion to D U patients.