Effect of intraduodenal acid on the pre- and postvagotomy basal gastric secretion and gastrin
Acid instillation into the duodenum inhibits basal and stimulated gastric secretion. In man vagotomy suppresses this secretory inhibition. It is postulated that such inhibition responds to a dual mechanism: an hormonal one (enterogastrone) and a nervous one (vagus nerve). This study showed that preo...
Guardado en:
| Autor principal: | |
|---|---|
| Otros Autores: | , , |
| Formato: | Capítulo de libro |
| Lenguaje: | Inglés |
| Publicado: |
1977
|
| Acceso en línea: | Registro en Scopus Handle Registro en la Biblioteca Digital |
| Aporte de: | Registro referencial: Solicitar el recurso aquí |
| Sumario: | Acid instillation into the duodenum inhibits basal and stimulated gastric secretion. In man vagotomy suppresses this secretory inhibition. It is postulated that such inhibition responds to a dual mechanism: an hormonal one (enterogastrone) and a nervous one (vagus nerve). This study showed that preoperative duodenal acidification of duodenal ulcer patients results in a decrease in basal gastric secretion and in gastrin levels. On the contrary, in patients submitted to vagal denervation-either through truncal division or highly selective vagotomy-duodenal acidification does not inhibit gastric secretion; however, a drop occurs in basal gastrin levels. An intact gastric vagal innervation therefore, seems necessary for the preservation of the sensitivity of the parietal cell to the effect of hormonal inhibitors, it being immaterial whether duodenal innervation is present or not, as that duodenal acidification provokes a significant fall in serum gastrin levels as determined by radioimmunoassay. This hormonal decrease produced by duodenal acidification can be explained by the inhibition of gastrin release from the antrum. Agreement is expressed with the opinion of other authors that highly selective vagotomy does not appear to carry any advantage over truncal section of the vagus nerves from the standpoint of the inhibitory mechanism of gastric secretion from the duodenum. © 1977. |
|---|---|
| Bibliografía: | Andersson, Inhibitory effects of hydrochloric acid in antrum and duodenum on gastric secretory responses to test meal in Pavlov and Heidenhain pouch dogs (1960) Acta Physiol. Scand, 49, p. 231 Becker, Evans, Reeder, Duodenal acidification and antral release of gastrin (1974) Arch. Surg, 108, p. 205 Brooks, Grossman, Effect of secretin and cholecystokinin on pentagastrin-stirrmlated gastric secretion in man (1970) Gastroenterology, 59, p. 114 Davidson, Urushibara, Thompson, Similarity of action of pentagastrin and pancreozymincholecystokinin on the isolated stomach and pancreas (1968) Surg. Forum, 19, p. 227. , ed. 2 Day, Webster, The autoregulation of the gastric secretion (1935) Am. J. Dig. Dis, 2, p. 527 Dinoso, Chey, Lorber, Effect of secretin and motor function of the upper gastrointestinal tract in man (1966) Clin. Res, 14, p. 295 Dragstedt, Role of the vagus nerves in the physiology of gastric secretion (1969) Am. J. Surg, 117, p. 813 Dragstedt, Duodenal inhibition of gastric secretion (1969) Am. J. Surg, 117, p. 841 Gillespie, Grossman, Inhibitory effect of secretin and cholecystokinin on Heidenhain pouch responses to gastrin extract and histamine (1964) Gut, 5, p. 342 Greenlee, Longhi, Guerrero, Inhibitory effect of pancreatic secretin on gastric secretion (1957) Am J Physiol, 190, p. 396 Hansky, Soveny, Korman, Effect of secretin on serum gastrin as measured by immunoassay (1971) Gastroenterology, 61, p. 62 Itoh, Takeuchi, Aizawa, The negative feedback mechanism of gastric acid secretion: Significance of acid in the gastric juice in man and dog (1975) Surgery, 77, p. 648 Johnson, Grossman, Intestinal hormones as inhibitors of gastric secretion (1971) Gastroenterology, 60, p. 120 Johnston, Duthie, Inhibition of gastric secretion in the human stomach (1965) Lancet, 2, p. 1032 Johnston, Duthie, Effect of fat in the duodenum on gastric acid secretion before and after vagotomy in man (1969) Scand. J. Gastroenterol, 4, p. 561 Johnston, Wilkinson, Highly selective vagotomy without a drainage procedure in the treatment of duodenal ulcer (1970) Br. J. Surg, 57, p. 289 Jordan, Jr., Peterson, Effects of secretin upon gastric secretion (1962) Ann. Surg, 156, p. 914 Konturek, Grossman, Effect of perfusion of intestinal loops with acid, fat or dextrose on gastric secretion (1965) Gastroenterology, 49, p. 481 Linares, Bordoli, Inhibición duodenal de la secreción gástrica (1972) Bol. Trab. Acad. Argent. Cirug, 56, p. 522 Lucas, Magee, Nakajima, Pancreozymin-cholecystokinin, a physiological mediator of gastric secretory inhibition of duodenal origin (1968) Experientia, 24, p. 570 Mazure, Cosen, Schraier, Acción de algunas drogas sobre el pH duodenal (1970) Acta Gastroenterol. Latinoam, 2, p. 1 Meyer, Way, Grossman, Pancreatic bicarbonate response to various acids in duodenum of the dog (1970) Am. J. Physiol, 219, p. 964 Nakajima, Magee, Influences of duodenal acidification on acid and pepsin secretion of the stomach in dogs (1970) Am. J. Physiol, 218, p. 545 Petersen, The effect of secretin on the basal gastric acid secretion in man (1969) Scand. J. Gastroenterol, 4, p. 609 Preshaw, Grossman, Stimulation of pancreatic secretion by extracts of the pyloric gland area of the stomach (1965) Gastroenterology, 48, p. 36 Shay, Gershon-Cohen, Fels, A selfregulatory duodenal mechanism for gastric acid control and an explanation for the pathologic gastric physiology in uncomplicated duodenal ulcer (1942) Am. J. Dig. Dis, 9, p. 124 Sokolov, Secretory mechanisms of digestive glands (1950) 1904 Thesis, p. 642. , ed. 2, Paul B. Hoeber, Inc., Medical Book Division of Harper & Row, Publishers, New York, St. Petersburg, quoted by Babkin, B. P Thomas, Crider, A quantitative study of acid in the intestine as a stimulus for the pancreas (1940) Am. J. Physiol, 131, p. 349 Uvnäs, Role of duodenum in inhibition of gastric secretion (1971) Scandinavian Journal of Gastroenterology, 6, p. 113 Ward, The effect of vagotomy on the inhibition of gastric secretion by intraduodenal acid (1974) Br. J. Surg, 61, p. 698 Ward, Bloom, The role of secretin in the inhibition of gastric secretion by intraduodenal acid (1974) Gut, 15, p. 889 Woods, Secretin inhibition of gastric hydrochloric acid in human beings (1965) Surg. Forum, 16, p. 315. , ed. 2 Wormsley, Gastric response to secretin and pancreozymin in man (1968) Scand. J. Gastroenterol, 3, p. 632 Wormsley, Response to duodenal acidification in man. II. Effects on the gastric secretory response to pentagastrin (1970) Scand. J. Gastroenterol, 5, p. 207 |
| ISSN: | 00396060 |