Cephalic phase ofgastric secretion inhealthy subjects andduodenal ulcer patients: role ofvagal innervation

SUMMARY In10healthy subjects and25duodenal ulcer patients, gastric acid andpepsin andserum gastrin responsestocephalic-vagal stimulation induced bymodified sham-feeding (MSF)were studied before andafter vagotomyandatropinisation andcompared withthose tomaximal stimulation withpentagastrin. WhentheMSF-induced peakacid output was normalised asapercentage ofpeak responsetopentagastrin itwas about 62% inhealthy subjects and66% induodenal ulcer patients. Serumgastrin concentration was notchanged significantly bymodified sham-feeding either innormal subjects orinduodenal ulcer patients. Truncal vagotomycompletely abolished gastric acid andpepsin responsestoMSF induodenal ulcer patients. Atropine almost completely suppressed gastric acidandpepsin responsestoMSF inhealthy subjects andreduced those induodenal ulcer patients byabout 62%.Thecombination ofthemodified sham-feeding andpentagastrin infusion resulted inaugmentation oftheacid outputinduodenal ulcer patients butnotinhealthy subjects. Thisstudy shows that thecephalic phase results inapotent gastric acid andpepsin stimulation whichisnotaccompanied byanychange inserumgastrin concentration either inhealthy subjects orduodenal ulcer patients andwhich isabolished byvagotomyandsuppressed byatropine.