Assessment of the 'mucus-bicarbonate' barrier in the stomach of patients with chronic gastric disorders.

The composition of gastric mucus and the amount of gastric bicarbonate secretion have been investigated in 26 subjects including healthy controls, duodenal ulcer patients and subjects with chronic gastric disorders (benign gastric ulcer or chronic superficial gastritis). Qualitative changes in gastric mucus (expressed as a reduction in the values of 'mucoprotective index') were found in the gastric ulcer group, but not in patients with chronic superficial gastritis. Basal bicarbonate secretion was significantly reduced (p less than 0.01) in subjects with gastric ulcer and chronic gastritis, compared with healthy controls. Mucus secretion and bicarbonate production proved to be normal in duodenal ulcer patients. Our results support the concept that impairment of the 'mucus-bicarbonate' barrier is an important pathogenetic factor in gastric ulcer and chronic gastritis.