Q. What causes these erosions to take place in a healthy person?
A. The basic cause is too much acid and pepsin in the gastric fluid. At all times, a continual battle is going on in the stomach. On one hand, glands in the walls are actively producing acid, which in turn allows production of pepsin, and these two liquids commence digestion of the food. This means it is broken down into its basic component parts which will allow it to be absorbed by the blood stream further down in the intestinal canal. On the other hand, the mucosal lining has to resist the action of these chemicals on itself, for it is also subject to being digested — a case of the body actually devouring itself! Normally, the two remain in a fairly stable equilibrium, and no harm occurs; food is broken down, and the stomach wall remains intact.
Q. Do ulcer patients produce too much acid and pepsin?
A. In most cases, probably all, the answer must be ‘Yes’. Often this is not so with stomach ulcers, but it has been found that in many cases of duodenal ulcer, acid production is three times that of normal. Imagine that hot burning acid being present in three times the normal volume. We have already pointed out the extremely strong burning nature of hydrochloric acid — as every plumber who solders knows — and this may act for hours on the lining of the intestine. No wonder that little craters and holes develop.
In a particular disorder called the Zollinger-Ellison syndrome, acid production is stimulated to incredibly high levels and as much as eight times normal acid production occurs. Little wonder these patients suffer from serious ulcers.
Q. If there is no acid present, does that mean no ulcers?
A. The reverse holds true. Excess acid and there is a high risk of ulcers. No acid, so called achlorhydria, and there is no chance of an ulcer developing.