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JAMA. 1963;186(4):423-424. doi:10.1001/jama.1963.03710040149016.
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The influence of liver disease on gastric acid secretion, as well as the relationship of cirrhosis of the liver to peptic ulcer and peptic esophagitis, has received considerable attention in recent years. Whether or not a relationship exists is uncertain. Studies in animals have shown that liver damage, common bile duct obstruction, or portal hypertension results in a marked increase in gastric acid secretion and enhances the production of experimental ulcers. In man, however, the association of peptic ulcer and liver disease has not been clearly established. The reported incidence of peptic ulcer in patients with cirrhosis has varied from 3.2%,1 which was similar to that in a control population, to 17%, an abnormally frequent occurrence.2 One study of gastric secretion in cirrhotics revealed histamine anacidity in one third of the patients with decompensated cirrhosis.3

Some uncertainty has existed, also, regarding the exact cause of esophageal varix


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