Pyloric-Sphincter Dysfunction in Patients with Gastric Ulcer

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Abstract
To determine whether alterations of pyloric-sphincter pressure are involved in the increased duodenogastric reflux in patients with gastric ulcer, pyloric-sphincter pressure was measured in 10 patients, both while their ulcer was active and after healing. Basal pressures in the patients with gastric ulcers did not differ from those in normal persons. Although pyloric pressure increased in normal subjects during either endogenous release or exogenous administration of secretin and cholecystokinin, patients with gastric ulcer showed no response. In normal subjects, during duodenal acidification, duodenogastric reflux significantly diminished as pyloric pressure increased, but not in patients with gastric ulcer. After healing of the ulcer, the pyloric sphincter still showed no response to hormonal stimulation. These studies suggest that in patients with gastric ulcer, pyloric-sphincter dysfunction is responsible for increased duodenogastric reflux.