Gastric osmolar clearance and ionic barter: two mechanisms of electrolyte secretion by the human stomach

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Abstract
Measurements of gastric juice volume (V) and H ion (H), chloride ion (ClG), Na ion (NaG) concentrations and of osmolality (OG) as well as plasma sodium (NaP) and osmolality (OP) were made in nine men before and after a subcutaneous injection of histamine. The gastric osmolar clearance (GOC) was calculated from the formula (V·OG)/OP and this correlated well with both acid and chloride output. The theoretical clearance of sodium (TCNa) was calculated for each specimen by the formula (V·OG·NaP)/OP, and this equaled the output of acid plus sodium in the gastric juice V(H + NaG). The mol-mol relationship furthermore suggests that the gastric acid is secreted on a 1:1 basis in exchange for Na ions theoretically cleared within the framework of a gastric osmolar clearance mechanism. It also explains why, even under the most optimal conditions in man, the maximum value for H+ concentration does not exceed 150 mEq/l. On the basis of these observations it is suggested that the various theories which propose a primary acid secretion of 167, 169, 208 or 464 mn, respectively, are unlikely. Submitted on January 22, 1960

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