Various hypotheses have been advanced in explanation of the pain in duodenal ulcer. This pain has been ascribed to irritation of exposed nerve endings in the ulcer base by the acid gastric juice, or to sensitization of the pain-producing mechanism in some way by acid. Bonninger,1 Palmer2 and others hold such views. Mechanical irritation by coarse particles of food is the cause assigned by Pick.3 Spasm of the pyloric sphincter or of the duodenal cap has been put forward by Glaessner and Kreuzfuchs4 and many others. Tension, due to an inhibition of relaxation of the pyloric sphincter, combined with strong gastric peristalsis, has been advanced by Hurst5 as the cause. That distention of the stomach is an important element in the pain of gastric ulcer and that this pain is readily relieved by passing a tube into the stomach is stated by Poulton.6 That the pain is possibly due to
WILSON MJ. DUODENAL ULCEROBSERVATIONS ON THE BEHAVIOR OF STOMACH AND DUODENUM IN THE PRESENCE OF PAIN. Arch Intern Med (Chic). 1928;41(5):633–641. doi:10.1001/archinte.1928.00130170020003
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