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Ammonia is produced when urea passes from the blood into gastric secretion, a reaction catalyzed by a urease, present in the gastric mucosa of man and several animals (1-14). Fitzgerald and Murphy (15) have suggested that the ammonia formed in this process may have an important protective function by neutralizing gastric acidity. This concept was based on the observation in man that administration of urea in amounts sufficient to raise temporarily the blood urea level by 12 mg. per cent was followed by a decrease of gastric acidity. Burke and Page (16) were unable to confirm these findings, and Kornberg, Davies and Wood (17-19) presented evidence which suggested that, at least in the cat, the urease found in the stomach is of bacterial origin and does not influence gastric acid secretion. This paper compares gastric ammonia and acid contents in normal and uremic subjects, the latter known to exhibit an elevated gastric ammonia concentration (20-22). Because of the influence of antibiotics on intestinal ammonia production (23-25), their effects on gastric ammonia and acid concentration were studied.

AMMONIA AS A SOURCE OF GASTRIC HYPOACIDITY IN PATIENTS WITH UREMIA *