Summary and conclusions
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1.
The important “ulcer-bearing” first part of the duodenum in normal persons is an acid area with an average pH in the fasting state of about 5.6 and after an Ewald meal of about 5.0.
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2.
The duodenal bulb in normal subjects is endowed with a capacity to neutralize, buffer and dilute gastric chyme that generally exceeds the physiologic needs.
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3.
Free acid is usually but not constantly absent in the contents of the duodenal bulb in normal people; its presence cannot be construed as an abnormal finding.
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4.
The neutralizing ability of the contents of the first part of the duodenum is ineffective (pH 3.5 or less) in many normal subjects at some time or other after an Ewald meal. Usually, however, the extent to which the neutralizing ability is overcome is not great, and the duration of its ineffectiveness is short.
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5.
None of the customary measures of gastric acidity in normal persons can be used as a reliable index of the behavior of the corresponding effective acidity (pH) of the duodenal bulb contents.
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6.
The acidity of the gastric contents is not the only factor which determines the reaction of the contents of the first part of the duodenum.
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7.
The neutralizing power of the contents of the duodenal bulb in normal man is not as great as in normal dogs.
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Aided by a Grant from John Wyeth & Bro., Inc.
Ross V. Patterson Fellow in Gastro-Enterology. Portion of Thesis submitted by Dr. Berk to the Faculty of the Graduate School of Medicine of the University of Pennsylvania in partial fulfillment of the requirements for the Degree of Doctor of Medical Science (D.Sc. (Med.)) for graduate work in internal medicine.
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Edward Berk, J., Rehfuss, M.E. & Earl Thomas, J. The acidity of the “ulcer-bearing area” of the duodenum in normal persons. Jour. D. D. 9, 276–281 (1942). https://doi.org/10.1007/BF02997906
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DOI: https://doi.org/10.1007/BF02997906