Abolition of postprandial alkaline tide in arterialized venous blood of duodenal ulcer patients with cimetidine and after vagotomy.

OBJECTIVE

Alkaline tide is the observed alkalinization of blood and urine after stimulation of gastric acid secretion. In previous studies, we found good correlation between gastric acid output and alkaline tide in arterialized venous blood.

METHODS

In the present study, the alkaline tide phenomenon was further investigated in 26 duodenal ulcer patients (seven post-vagotomy) after a test meal, before and after cimetidine pretreatment.

RESULTS

Alkaline tide was demonstrated in everyone of the 19 duodenal ulcer nonvagotomized patients but in only two of the seven vagotomized patients; base excess mean rise of 1.05 +/- 0.14 mEq/L/45 min versus -.07 +/- 0.23 mEq/L/45 min (mean +/- SE, p < 0.001). Decrease in alkaline tide after cimetidine was demonstrated in the nonvagotomized group: 1.05 +/- 0.14 mEq/45 min versus -0.03 +/- 0.16 mEq/45 min, before and after cimetidine, respectively (mean +/- SE, p < 0.001). Urinary alkaline tide was demonstrated in only 4/19 and 2/19 of the first group (with and without cimetidine, respectively) and in only 1/7 of the post-vagotomy group.

CONCLUSIONS

Our results suggest an association between gastric acid secretion and blood alkaline tide, because both are inhibited by cimetidine or vagotomy.