title: Gastric juice acidity in upper gastrointestinal diseases.
abstract: OBJECTIVE
  To search the independent factors determining gastric juice acidity and to investigate the acidity of gastric juices in various benign and malignant upper gastrointestinal diseases.
  
  
  METHODS
  Fasting gastric juice acidity of 165 healthy subjects and 346 patients with esophageal ulcer (n = 21), gastric ulcer (n = 136), duodenal ulcer (n = 100) or gastric cancer (n = 89) were measured and compared. Additionally, gastric specimens were taken from the antrum and body for rapid urease test and histological examination.
  
  
  RESULTS
  Multivariate analysis revealed that bile stain of gastric juice, high acute inflammatory score of the corpus, and atrophy of the corpus were independent risk factors for the development of gastric hypoacidity with odds ratios of 3.1 (95% CI: 1.3-7.3), 3.1 (95% CI: 1.2-7.9) and 3.5 (95% CI: 1.3-9.2). Esophageal ulcer and duodenal ulcer patients had a lower pH level (1.9 and 2.1 vs 2.9, both P < 0.05) of gastric juices than healthy subjects. In contrast, gastric ulcer and gastric cancer patients had a higher pH level (3.4 and 6.6 vs 2.9, both P < 0.001) than healthy controls. Hypoacidity existed in 22%, 5%, 29%, 5% and 88% of healthy subjects, esophageal ulcer, gastric ulcer, duodenal ulcer and gastric cancer patients, respectively.
  
  
  CONCLUSIONS
  Bile reflux, atrophy and dense neutrophil infiltrate of the corpus are three independent factors determining the acidity of gastric juice.
authors.affiliation: Institute of Clinical Medicine, National Cheng Kung University, Tainan 701, Taiwan, China.
authors.forename: Pei-Jung
authors.initials: PJ
authors.lastname: Lu
authors.forename: Ping-I
authors.initials: PI
authors.lastname: Hsu
authors.forename: Chung-Hsuan
authors.initials: CH
authors.lastname: Chen
authors.forename: Michael
authors.initials: M
authors.lastname: Hsiao
authors.forename: Wei-Chao
authors.initials: WC
authors.lastname: Chang
authors.forename: Hui-Hwa
authors.initials: HH
authors.lastname: Tseng
authors.forename: Kung-Hung
authors.initials: KH
authors.lastname: Lin
authors.forename: Seng-Kee
authors.initials: SK
authors.lastname: Chuah
authors.forename: Hui-Chun
authors.initials: HC
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001284:Atrophy / Q000503:physiopathology; D001655:Bile Reflux / Q000503:physiopathology; D016022:Case-Control Studies; D004381:Duodenal Ulcer / Q000473:pathology / Q000503:physiopathology; D004935:Esophageal Diseases / Q000473:pathology / Q000503:physiopathology; D005260:Female; D005750:Gastric Juice / Q000502:physiology*; D005767:Gastrointestinal Diseases / Q000473:pathology* / Q000503:physiopathology*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D008875:Middle Aged; D020556:Neutrophil Infiltration / Q000502:physiology; D013276:Stomach Ulcer / Q000473:pathology / Q000503:physiopathology; D014456:Ulcer / Q000473:pathology / Q000503:physiopathology