THE METHOD OF THE INVESTIGATION OF GASTRIC SECRETION WITH THIN
TUBE WITH HISTAMINE STIMULATION USING.
Drug treatment is ceas.ed one day before investigation. The investigation must be
carry out on empty stomach in the morning. Saliva mustn’t be swallowed during
investigation.
Thin zond is injected to patient in sitting position. The time of injection mustn’t be
more than 5 minutes. To place zond in distal gastric part, it’s necessary to inject zond on
deepth, which is even the partient height minus 100 in cm. It"s necessary to remove com-
pletely the gastric content on empty stomach. After that four 15-minute portions are gotten
during hour. lt"s basal secretion (BAO). 30 minutes later investigation beginning 1 ml of 1%
dimedrolum solution or 2 ml of 2,5% pipolphenum one or 2 ml 2% suprastinum one are in-
jected subcutaneously (they decrebke the general to'ic action of histamine, don’t preserve its
action on gastric mucosa).
After BAO receipt 0,1% solution of histamine hydrochloridum (phosphate) in dose
0,lmg/10 kg b.w. is injected to patient and gastric juice is removed completely during one
hour every 15 minutes. Volume and acidity of gastric juice are detected in Lamblin"s
method.
The notions about submaximal stimulation is refered to simple histamine test - after
receipt of 4 BAO portions . 0,5 ml of 0,1% histamine solution is injected to patient and 4
juice portions are gotten during 1 hour.
Double - histamine test. o,5 ml of histamine solution is injected subcutaneously and 2
juice portions are gotten during 30 minutes after four BAO portions receipt and after that
histamine injection is repeated in the same dose and two 15-minute portions are gotten yet.
Maximal histamine test.
0,1% histamine solution (40 meg/kg) in dose 0,4 ml/10 kg b.w. is injected to patient
after four BAO portions receipt and after that four 15-minute juice portions are gotten .
Hastrin II in dose 2 meg/kg causes more expressed secretory effect than 40 meg/kg of
histamine. But in the last time pentagastrin (6 meg/kg s/c) changes the hastrin as more spread
syntethetic drug without general action.
HC1 debit detection.
HC1 debit in ohour (or another time interval) is expressed in milliequivalents or in
mg. These formules are used:
1. in mg: D-UxExO,0365 + UxExO.0365 + ...; D-debit, U -gastin juice portion volume in
ml, E - the HC1 concentration in titer units, 0,0365 - HC1 content in the 1 ml of juice in con-
centration, which is even titer unit.
2. in mequ.: D=UxE/1000 +UxE/1000 + ..., 1mequ=36,5 mg
NORMAL INDECES OF GASTRIC SECRETORY FUNCTION.
On empty stomach (hungry gastric residue).
Volume of Free General Debit Debit
gastric HC1 acidity of free of HCl
content HC1
to 50 ml to 20 t.u. to40t.u. to 1 mequ. to 2 mequ.
or to 40 mg or to 70 mg
Addition:
1. the hungry gastric content volume has the great meaning in the detection of gastric
evacuation function disorder;
2. the number of absolute HC1 content reflects the intensity of acid excretion in
interdigestive secretion period.
BASAL GASTRIC SECRETION (BAO).
Hour vol. Free HC1 Binded HCl General Debit/hour of Debit/hour of
of gastric acidity free HC1 common HC1
juice
50- 100ml 20-40 t u 10-l5 t.u 40-60 t.u 1-4 mequ. 40- l,5-5,5mequ
150mg 55-200g
Addition: 1. These normal indeces of hour HCl production refer to men before 30 years.
2. Normal indeces must be decreased on 20-30 % for women.
3. Secretion decreases on 50% in men and women after 40-50 years.
SECRETORY REACTION OF STOMACH ON STIMULATION
SUBMAXIMAL (SMAO) and MAXIMAL (MAO).
Stimul. Hour vol. Free Binded General Debit/hour Deb/h.
type gastric HC1 HC1 acidity free HC1 general
juice HC1
SMAO 100- 140ml 65-85 t.u. to 15t.u 80-100t.u 6,5-12mequ 8-14mequ
250-450mg 300-500mg
MAO 180-220ml 90-110 t.u. to 15t.u 100-120tu 16-24mequ 18-26mequ
600-900mg 650-950mg
Addition: the many investigations show that 15% of parietal cells provide basal secretion,
45% - submaximal histamine one and 90% - maximal one. Because of it the interconnection
of normal indeces of HC1 debit-hour must be 1:3:6.
THE INFLUENCE OF AGE AND SEX ON GASTRIC SECRETION.
It"s necessary to take into account sex and age for the correct detection of gastric
secretion. There is less amount of parietal cells in women, than in men (approximetely on
20%). Women are more inclined to reflex and neurogenic inhibition of gastric secretion.
Organic injuries of gastric-duodenal system occur rarely in them: ulceric disease, the cancer
of stomach, expressed forms of chronic gastritis. Even long-time achlorhydias don"t always
indicate to the atrophic changes of gastric mucosa. However, the expressed increase of acid
e