Secretion of water and electrolytes into the duodenum in normal subjects and in patients with cirrhosis: the response to secretin and pancreozymin.

The increased volume of duodenal juice secreted by cirrhotic subjects in response to secretin was confirmed in 10 patients when their response was compared with that in eight normal subjects. This volume increase was associated with an increased sodium and chloride output while bicarbonate output was normal. The increment in volume of juice secreted by the cirrhotic patients was thus made up of an isotonic sodium chloride solution. The differences in anion concentrations and outputs are similar to reported changes produced in normal subjects given increasing doses of secretin. On the basis of these observations it is suggested that the increased output of duodenal juice in cirrhotic patients may be due to the infused secretin exerting a greater effect than in normals, possibly consequent upon an impaired secretin removal rate in the abnormal liver.