Gastric acid secretion in patients with typhoid fever.
Gastric secretory studies were carried out in the following groups of patients: group A, 30 Salmonella typhi positive enteric patients, group B, 15 non-enteric fever patients and group C, 20 healthy controls. Patients with typhoid were divided into two subgroups on the basis of the severity of the disease: group A1 (17) consisted of uncomplicated cases of enteric fever and group A2 (13) comprised of those who had associated complications. During convalescence both groups of typhoid patients showed significantly lower basal acid output (BAO) and maximal acid output (MAO) levels compared with controls and patients with non-enteric fever. Patients in group A2 had significantly lower MAO levels compared with group A1 but the BAO levels showed no such difference. In contrast BAO and MAO levels during convalescence in patients with non-enteric fever were similar to those in the control group. After two months, there was a significant increase in both the BAO and MAO levels in groups A1 and A2. The levels in group A2, however, remained significantly lower compared with group A1, controls and patients with non-enteric fever. Histologically, the gastric mucosa did not show any significant abnormality in either group of typhoid patients. The results suggest that depressed gastric secretion is the result of enteric infection and is related to the severity of the disease process.
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