Studies on Uropepsin Excretion, Maximal and Basal Acid Output in Recurrent Peptic Ulcer

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Abstract
The value of testing uropepsin excretion, basal acid output, and maximal acid output following histamine was investigated in 20 patients with and 22 patients without recurrent peptic ulcer following partial gastrectomy. Determination of the 24-hr, uropepsin is of a certain importance in diagnosing recurrent peptic ulcer. Excretion exceeding 150 units/24 hr. was found in 65% of the ulcer group as compared with only 9% of the control group. Values in excess of 200 units/25 hr. are strongly suggestive of recurrent ulcer, while values below 70 units/24 hr. definitely indicate that it is not present. Determination of the basal acid output is of no diagnostic value in recurrent peptic ulcer. Determination of the peak acid output [PAO] is of a certain diagnostic importance in recurrent peptic ulcer. A PAO value greater than 10 mEq/hr. was found in 50% of the ulcer group, but in only 9% of the control group. Achlorhydria (pH > 3.5) was not found in any case of the ulcer group, but incidentally it is impossible to state a bottom level of PAO below which recurrent ulcer does not develop. A combination of uropepsin and PAO determination increases the diagnostic value presumably because pepsin and acid production does not occur in exactly the same parts of the stomach. A PAO value greater than 7 mEq/hr. or a uropepsin value greater than 150 units/24 hr. was found in 95% of the recurrence group and 23% of the control group.