Gastric Secretory Response to Emotional Stress in a Case of Duodenal Ulcer: A Consideration of a Possible Mechanism Involved

¹ From the Samuel S. Fels Research Institute and Temple University Medical Center, Philadelphia, Pennsylvania

Thirty-four gastric secretory studies were done on a patient with duodenal ulcer within a period of 21 months. Fourteen of these studies are reported in this paper and were concerned with the immediate effect of emotional stress on gastric secretion. Each study involved a 6-hour basal secretory period. Emotional stress was produced by a psychological interview. Nine consecutive control studies were done during a 7-month period. Studies with psychological interviews, with or without drugs and control studies without interview were interspersed at intervals. On the day of experiment with a psychological interview, 1-hour basal gastric secretion was collected; the psychiatrist then entered the laboratory and conducted the interview for 30 minutes and withdrew. The patient did not know on which experimental day the psychiatrist would appear. Emotional stress, induced by the psychological interview, produced a significant increase in total acid output with a smaller peak in the first 2 hours and a larger peak in the 3rd and 4th hours. These two phases of increased gastric secretion after the interview are similar to those produced by the stress effect of insulin hypoglycemia. An anticholinergic agent, Elorine sulfate, or an adrenergic blocking agent, Regitine, blocked the secretory response induced by the interview. A working hypothesis for the possible mechanism involved in the increase of gastric secretion by emotional stress is suggested.