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Ionic Changes in Pavlov Pouches After Insulin Hypoglycemia, Gastrin, and Pentagastrin

Ross K. Adair, MD; George K. Wlodek, MD, FRCS
Arch Surg. 1968;97(3):423-436. doi:10.1001/archsurg.1968.01340030083007.
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THE EXTERNAL output of acid by the stomach has been assumed by many to be a direct measurement of the secretory state of the parietal cell mass. However, it is now generally accepted that the primary acid secretion of the stomach is altered by some mechanism which has been called acidity control. Pavlov's suggestion that gastric mucous or duodenal regurgitation was responsible for acidity control has little support at the present time. Two conflicting theories are now considered pertinent. Hollander1 has formulated the two-component theory of acid secretion which hypothesizes a concurrent secretion of an alkaline solution by the gastric mucosa, which partially dilutes and neutralizes the primary acid secreted by the parietal cells. This theory has gained recent support from Gray and Bucher2 and Makhlouf et al.3 In 1933, Teorell4 proposed that acidity control was accomplished by an exchange-diffusion of intraluminal hydrogen ions for interstitial


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