ADRENAL INFLUENCES ON THE STOMACH: PEPTIC ULCER IN ADDISON'S DISEASE DURING ADRENAL STEROID THERAPY

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Abstract
The present study emphasized the significance of pituitary-adrenal influences upon the stomach, as evidenced by the following observations. A low incidence of chronic peptic ulcer and a decrease in gastric activity are characteristic findings in patients with Addison''s disease. Bilateral adrenalectomy reduces gastric volume and acidity in experimental animals and is accompanied by an associated involution of the gastric tubular cells. Low uropepsin excretion is invariably found in Addison''s disease patients, with a return to normal or elevated levels during replacement gluco-corticoid therapy. Increased uropepsin excretion occurs in states of adrenal hyperactivity (Cushing''s disease). Exaggerated gastric response to administered adrenal steroids occurs in the Addisonian and in patients following bilateral adrenalectomy. Chronic peptic ulcer de novo or reactivation of symptoms of a previously existing ulcer was demonstrated in Addison''s disease patients receiving cortisone replacement therapy. Antacid therapy may be indicated in Addison''s disease patients maintained on long-term glucocorticoid therapy.