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gastric acid secretion
Indications:
- Zollinger-Ellison syndrome
- retained antrum syndrome
- *G-cell hyperplasia
- vagal hyperfunction
Contraindications:
contraindications for gastric intubation
1) esophageal varices
2) diverticula
3) esophageal stenosis
4) malignant neoplasm of the esophagus
5) aortic aneurysm
6) severe gastric hemorrhage
7) congestive heart failure
Normal range:
1) normal pH of stomach is 1-2 [3]
2) basal secretion
a) male: 0-10 meq HCl/hour
b) female: 0-6 meq HCl/hour
3) peak secretion (after pentagastrin stimulation)
a) male: 12-60 meq HCl/hour
b) female: 8-40 meq HCl/hour
c) peak response in 15-45 min SC; 10-30 min IM
Procedure:
1) pass Levin tube
2) confirm position by X-ray or fluoroscopy
3) basal output: collect 2 15 minute specimens or a 12 hour nocturnal* collection
4) pentagastrin 6 ug/kg SC or IM
5) peak output: collect 6 15 minute specimens after stimulation
6) specimens are collected with the patient in an uright position
* for nocturnal collection, patient must remain in uright position & gastric acid must be aspirated continuously
Clinical significance:
- basal gastric output (BAO) follows a circadian pattern
- it is highest from 1400-2300 hours
- peak gastric output (PAO) may be as high as 60 meq/hour in some normal individuals
- values > 60 meq/hour (> twice BAO) are suggestive of Zollinger-Ellison syndrome
- BAO/PAO values of > 0.6 are common in patients with Zollinger-Ellison syndrome
Increases: (increased BAO)
1) peptic ulcer (5-15 meq/hour)
2) Zollinger-Ellison syndrome (> 20 meq/hour
-> values as high as 60 meq/hour) are common
3) retained antrum syndrome
4) G-cell hyperplasia
5) vagal hyperfunction
6) systemic mastocytosis
7) basophilic leukemia
Decreases: (decreased gastric acid output)
1) pernicious anemia (no gastric acid output)
2) gastric ulcer (some)
3) carcinoma of the stomach
4) chronic gastritis
5) gastric polyps
6) myxedema
7) vagotomy
8) antrectomy
Related
gastric acid (stomach acid)
gastric fluid
gastrin in serum
peptic ulcer disease (PUD)
Zollinger-Ellison (ZE) syndrome (gastrinoma)
Specific
gastric acid free secretion
General
special chemistry test
References
- Medical Knowledge Self Assessment Program (MKSAP) 11, American
College of Physicians, Philadelphia 1998
- Clinical Guide to Laboratory Tests, 3rd ed. Teitz ed.,
W.B. Saunders, 1995
- Wikipedia: Gastric acid
http://en.wikipedia.org/wiki/Gastric_acid