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December 14, 1963

Intestinal Sensitivity to Gastric Juice

JAMA. 1963;186(11):1002-1004. doi:10.1001/jama.1963.63710110009010b

ACID-PEPTIC DIGESTIVE CAPACITY and mucosal resistance are the ultimate opposing factors in the peptic ulcer diathesis. The buffering and diluting qualities of the gastrointestinal contents can modify an imbalance between these two factors and undoubtedly play a major role in the prevention of ulcer. One question frequently raised is: Does mucosal susceptibility increase progressively from duodenum to ileum? Clinical observations tend to affirm this concept.1 Much of the early experimental work seems to support it.2-4 However, recent investigations by Merendino and his co-workers question the validity of an increasing aboral sensitivity of the intestinal mucosa to acidpeptic destruction.5-8 They bring forth convincing arguments against the conclusions drawn by earlier workers.

The first indication that the jejunum might be more sensitive to gastric juice than the duodenum came from an experiment by Mann and Kawamura in 1922.9 They resected the duodenum and replaced it with the

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