AN ASSESSMENT OF THE AUGMENTED HISTAMINE TEST IN THE DIAGNOSIS OF PEPTIC ULCER. CORRELATIONS BETWEEN GASTRIC SECRETION, AGE AND SEX OF PATIENTS, AND SITE AND NATURE OF THE ULCER.

Patients with peptic ulcer, radiologically negative dyspepsia, and gastric carcinoma have been studied with the modified augmented histamine test described in the previous paper. For each disease a range of values is presented and compared with the normal range, taking account of age and sex. The test may be of diagnostic value because comparison of an observed result with the ranges presented may show that a disorder, for example duodenal ulcer, is almost certainly present or almost certainly not present. Thus, in duodenal ulcer about half the values of peak acid output were above the normal range, and there was a threshold figure for peak acid output below which patients with duodenal ulcer were not found. There was a gradient for peak acid output in patients with ulcers at different sites so that ulcers in the body of the stomach < near the angulus < prepyloric < duodenal ulcers. Normal acid output did not exclude carcinoma of the stomach. Abnormally high basal or peak acid output in patients with dyspepsia but negative barium meals may suggest the presence of peptic ulceration.