THE EFFECT OF X-RAY THERAPY ON GASTRIC ACIDITY AND ON 17-HYDROXYCORTICOID AND UROPEPSIN EXCRETION

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Abstract
Free gastric hydrochloric acid is essential for the production of peptic ulcer. It is possible by X-radiation to decrease or even abolish production of this acid, leading to subsequent healing of the ulcer. These observations serve as the rationale for the clinical use of X-ray therapy in the management of peptic ulcer. A study was undertaken in 14 patients with peptic ulcer. X-ray radiation of the stomach for the treatment of the ulcers resulted in a clinical remission in 12 patients and a reduction in gastric acidity in all. Uropepsin excretion was consistently and significantly increased during or immediately after X-ray therapy and subsequently fell approximately to control levels. This rise was much greater in patients in whom hydrochloric acid secretion was markedly reduced. An occasional patient showed a marked, persistent reduction. Rise in uropepsin excretion after treatment suggests that radiation causes an alteration in function or permeability of the chief cells, leading to a change in the direction of diffusion of pepsinogen in favor of the blood stream. The 17-hydroxycorticoid excretion rose during and after X-ray radiation and subsequently fell toward control levels, although a few patients maintained a persistent elevation. This effect may be part of a general stress phenomenon. An early marked rise in uropepsin followed by a marked fall in gastric acidity may enable one to predict early which patients will have the best clinical response to irradiation therapy.