Document Detail


Gastric analysis with fractional test meals (ethanol, caffeine, and peptone meal), augmented histamine or pentagastrin tests, and gastric pH recording.
MedLine Citation:
PMID:  15075465     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
For centuries it was recognized that the stomach produces a juice, which has acidic properties, however, it was not until 1824 when Prout demonstrated the presence of hydrochloric acid in gastric juice. At the same time experiments on a patient with gastric fistula began by W. Beaumont showing alterations of acid secretion after meals and under various psychological conditions. After the discovery by L. Popielski in 1920 that histamine is a direct stimulant of oxyntic glands, histamine started to be used in the 1930s in gastric secretory tests. Then in 1949 the dose of histamine was established by K. Kowalewski to induce in humans maximal gastric secretion and in 1953 Kay from UK, using a similar dose of histamine (0.04 mg/kg), introduced augmented histamine test to determine maximal acid output. The digestive period of gastric secretion can be divided into 3 phases: cephalic phase, gastric phase, and intestinal phase. When an acidified meal reaches the antrum or proximal part of the small intestine, the inhibitory autoregulatory mechanisms are triggered. Using a peptone meal as a physiological stimulant of gastric secretion, Fordtran and Walsh designed in 1973 the intragastric titration method. Histamine stimulates H1 and H2 receptors, producing some side effects so Betazole (Histalog), an analogue of histamine was introduced, because of smaller side effects than with histamine. In 1967, pentagastrin, which contains a C-terminal amino-acid sequence of gastrin and does not exert serious side effects, was applied first in Poland as a stimulant of gastric acid secretion instead of histamine. At the present time, a 12 or 24 h pH-metry with a magnetic recording of gastric acidity using the Digitrapper was found to have a greater diagnostic value in assessment of gastric acid secretion under natural conditions including meal than classic gastric secretory tests. This technique has been widely used in detecting the duodeno-gastric or gastro-esophageal reflux (GERD) and testing various drugs affecting gastric acid secretion and healing acid-pepsin disorders.
Authors:
S Kwiecień; S J Konturek
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Publication Detail:
Type:  Historical Article; Journal Article    
Journal Detail:
Title:  Journal of physiology and pharmacology : an official journal of the Polish Physiological Society     Volume:  54 Suppl 3     ISSN:  1899-1505     ISO Abbreviation:  J. Physiol. Pharmacol.     Publication Date:  2003 Dec 
Date Detail:
Created Date:  2004-04-12     Completed Date:  2008-01-08     Revised Date:  2008-05-19    
Medline Journal Info:
Nlm Unique ID:  9114501     Medline TA:  J Physiol Pharmacol     Country:  Poland    
Other Details:
Languages:  eng     Pagination:  69-82     Citation Subset:  IM    
Affiliation:
Department of Physiology, Jagiellonian University Medical College, Cracow, Poland.
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MeSH Terms
Descriptor/Qualifier:
Caffeine / administration & dosage,  history*
Ethanol / administration & dosage,  history*
Gastric Juice / chemistry*,  secretion
Histamine / history*
History, 19th Century
History, 20th Century
Humans
Hydrogen-Ion Concentration
Pentagastrin / administration & dosage,  history*
Peptones / administration & dosage,  history*
Chemical
Reg. No./Substance:
0/Peptones; 51-45-6/Histamine; 5534-95-2/Pentagastrin; 58-08-2/Caffeine; 64-17-5/Ethanol

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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