The Relationship between Gastric Juice Nitrate/Nitrite Concentrations and Gastric Mucosal Surface pH

PURPOSE: To investigate gastric juice nitrate/nitrite concentration according to mucosal surface pH extent (area) of gastric corpus intimately contacting the gastric juice. MATERIALS AND METHODS: We included ninety-nine patients with dyspepsia. To evaluate gastric mucosal surface pH and its extent, gastric chromosocpy was performed by spraying phenol red dye on the corpus mucosa and estimating the extent of area with color changed. Nitrate/nitrite concentrations and pH of gastric juice were measured by ELISA and pH meter, respectively. Silver staining was done to histologically confirm the presence of Helicobacter pylori. RESULTS: Intragastric nitrate/nitrite concentrations in patients, showing phenol red staining mucosa were higher than those of unstaining mucosa (p=0.001): the more extensive in the area of phenol red staining area of corpus, the higher gastric juice pH found (r=0.692, p<0.001). Furthermore, the intragastric nitrate/nitrite concentrations correlated positively with gastric juice pH (r=0.481, p<0.001). CONCLUSION: The changes of mucosal surface pH and its extent in gastric corpus might affect either pH or nitrate/nitrite level of gastric juice.

[ effect of omeprazol and ranitidine on gastric acidity in ICU patients]

ICU patients especially those under mechanical ventilation or with a history of coagulation disorders are at the risk of stress ulcer development and related GI bleeding. Typically H2 blockers administration showed prophylactic role to control gastric acidity. Preliminary studies have shown that administration of intravenous omeperazol is effective. The object of this study was to compare the effect of oral rout administration of omerprazol with intravenous ranitidine on gastric pH. In this experimental study 40 ICU patients under mechanical ventilation allocated into same conditions and matched ranitidine and omeprazol groups [20 subjects in each group]. First group received 50 mg intravenous ranitidine twice per day and the second group received 40 mg oral omeperazol once a day. The gastric acidity was monitored using Chroning method. Gastric pH was determined before administration and three times per day after drugs administration then followed for three consequent days. Data was analyzed using T-test and SPSS software. The mean gastric pH in the Ranitidine group was 2.07 +/- 0.79 before and 2.80 +/- 0.85 after drug administration. In the Omperazol group gastric pH was 2.01 +/- 1.52 before and 3.90 +/- 1.52 after drug administration. The oral Omeperazol administration was significantly effective than intravenous Ranitidine administration [p<0.005]. Our data suggest that in critically ill patients oral rout administration of Omeparazol is more effective than intravenous H2 blocker [Ranitidine] to decrease gastric acidity and may prevent from stress ulcer

Effect of clmetidine on reduction of gastric secretion and pH in adult patients undergoing elective surgery and its impact on aspiration risk

Aspiration of gastric contents is rare, but serious and life threatening complication of general anaesthesia. Its severity depends upon the pH and volume of gastric contents. This study was conducted to evaluate the effect of pre-anaesthetic administration of oral Cimetidine on pH and volume of gastric contents in 116 adult inpatients of either sex, American Society of Anaesthesiologists physical status I-II, and aged 15-70 years. The patients in Group C [Control] received Placebo while Group T [Cimetidine 800 mg] orally at 9 PM, a night before elective surgery. Next day, Gastric contents were aspirated with a large bore, multi-orifices gastric tube passed through an endotracheal tube placed blindly in oesophagus after tracheal intubation and analysed for the presence of bile salts, pH and volume. Thirty-two samples [28.31%] out of 113 were contaminated with duodenal contents. Duodenogastric reiluxate significantly affected both the pH and volume of gastric contents in both groups. Cimetidine, after excluding contaminated cases either with duodenogastric refluxate or blood, did not significantly increase the pH [p=0.1221], decrease the volume of gastric contents [p=0.0816] and the proportion of the patients [25.64% versus 23.80%] considered [at risk] compared with Placebo [p=1.0000] according to the criteria defined [pH 25 ml]. Cimetidine 800 mg given orally at 9 PM did not provide adequate prophylaxis for acid aspiration syndrome at the time of induction of anaesthesia

Modulation of gastric mucosal mast cell population: role of vestibulo cerebellar lesion.

Posterior cerebellar lesion induced severe focal inflammatory ulcers at the stomach associated with extensive damage of the surface epithelial cells, leading to focal necrotic ulcers. The ulcer index increased maximally and progressively between day 7 and day 14 after lesion. The total mucosal mast cell and degranulated mucosal mast cell increased maximally on day 7 and progressively declined from day 14 to day 21. Gastric histamine content was also significantly increased on day 7 and 14. A significant reduction in mucous content (total CHO:P) was observed within 7-28 days after lesion. The results suggest that the gastric mucosal mast cells play an important role in ulcerogenesis induced by cerebellar lesion.

Effects of Preoperative Anxiety on Gastric Fluid Acidity and Volume

The aim of this study was to evaluate the effect of preoperative anxiety on the gastric pH and volume. We studied 96 female patients aged 16-60 yr who underwent elective gynecological surgery. We classified the subjects into 2 groups, those presenting preoperative anxiety scores using visual analogue scale (VAS, 0-10) less than 5 (L-group, n=59), and those with 5 and more (H-group, n=37). Immediately after tracheal intubation, gastric contents were aspirated using a 14-F multiorifice nasogastric tube. The gastric acidity and volume of the two groups were not statistically different. Mean pH were 3.0+/-1.8 and 3.0+/-2.0 in each group (L-group and H-group) and mean gastric volume (mL) were 15.3 +/-11.7 and 11.8 +/-11.8, respectively. Nine (15.3%) patients in the L-group were considered to be 'at risk i.e. gastric pH 25 mL' and one patient (2.7%) in the H-group (p<0.05). The mean serum gastrin concentrations in both groups were similar (21.6+/-9.8 vs. 20.2+/-11.0 pg/mL). The pH and volume of preoperative gastric contents were not correlated with the preoperative anxiety. The results suggest that a low level of preoperative anxiety can be considered a risk factor for aspiration pneumonitis.

Effect of Convolvulus pluricaulis Chois on gastric ulceration and secretion in rats.

Convolvulus pluricaulis is an indigenous plant commonly mentioned in Ayurveda, an ancient system of Indian medicine, as a rasayana which is mainly advocated for use in rejuvenation therapy. The present study was conducted to evaluate the potential anti-ulcerogenic effect of juice of fresh whole plants of C. pluricaulis (CPJ) against various experimental gastric ulcer models induced by ethanol, aspirin, 2 hr cold restraint stress and 4 hr pyloric ligation in rats. The drug was given orally twice daily for five days in the doses of 375 and 750 mg/kg body weight. CPJ showed anti-ulcerogenic effect at both doses in all the experimental gastric ulcer models and was comparable to the reference drug sucralfate (250 mg/kg). Gastric juice secretion and mucosal studies were undertaken to find out the possible mechanism of action of antiulcer effect by studying its effects both on offensive and defensive mucosal factors. The antiulcerogenic effect of CPJ was found to be due to augmentation of mucosal defensive factors like mucin secretion, lifespan of mucosal cells and glycoprotiens rather than on the offensive factors like acid-pepsin.

Experimental evaluation of Bocopa monniera on rat gastric ulceration and secretion.

The anti-ulcerogenic effect of fresh juice from the whole plant of Bocapa monniera Wettst. (BMJ) commonly known as Brahmi in Hindi was examined using gastric ulcer models induced by ethanol, aspirin, 2 h cold restraint stress and 4 h pylorus ligation. Bocapa monniera juice (BMJ) at doses of 100 and 300 mg/kg and sucralfate at a dose of 250 mg/kg were given orally, twice daily for 5 days. BMJ 100-300 mg/kg produced significant antiulcer activity in all the experimental gastric ulcer models except in case of ethanol-induced ulcers where 100 mg/kg was not found to decrease it significantly. BMJ (100-300 mg/kg) was found to have little or no effect on the offensive acid-pepsin secretion, while cell shedding (microgram DNA/mg of protein) and mucin secretion in terms of total carbohydrates:protein ration (TC:P), the two important parameters of defensive factors were significantly decreased and increased respectively indicating enhancement of protective mucosal factors. Both BMJ (300 mg/kg) and SF showed tendency to increase the mucosal glycoproteins in terms of TC:P, though individual carbohydrates and total carbohydrates were either increased or showed a tendency to increase. Thus, ulcer protective effect of BMJ may be due to its effect on mucosal defensive factors like enhanced mucin secretion, mucosal glycoprotein and decreased cell shedding rather than on offensive factors such as acid and pepsin.

Effect of cardamom oil on gastric secretions, gastric mucosa and induced contractions in rat stomach fundus

The aim of this work was to demonstrate the effect of cardamom oil on gastric secretions, gastric mucosa and induced contractionsin rat stomach fundus. This study was carried out on 40 rats divided into five groups each of 8 rats: Group 1: Control group. Group 2: Received a single dose of cardamom oil [5 ul Kg orally] Group 3: Received a single dose of cardamom oil [50 ul Kg orally] Group 4: Pretreated with cimetidine before cardamom administration. Group 5: Pretreated with atropine before cardamom oil. In all groups the gastric secretion was collected by pyloric ligation, for estimation of HCL concentration, mucin content and peptic activity. Furthermore. isolated stomach fundus strips were used for demonstration of cardamom oil effect on induced gastric contractions. The oil produced a dose dependent increase in both free and total gastric acidity as well as peptic activity. It also produced a slight increase in gastric mucin content. The oil at a dose of 5 ul/kg produced gastric hyperemia in 50% of rats, while a dose of 50 ul/kg produced mild gastric erosinos in 75% of the tested rats. Pretreatment with cimetidine [50 mg/kg] before administration of cardamom oil resulted in a significant reduction in both free and total gastric acidity as compared to that of the untreated animals. Moreover, pretreatment with atropine [1 mg/kg] before administration of cardamom Oil also produced a significant reduction in free and total gastric acidity as compared to that of the untreated animals. Additionally, the oil inhibited the histamine induced stomach fundus contractions on one hand and enhanced that induced by acetylcholine on the other. Cardamom oil has a stimulatory effect on gastric secretion

Effect of cimetidine, ranitidine and tiotidine on histamine stimulated gastric acid secretion in intact rats under local conditions

Antisecretory effects of cimetidine, ranitidine and tiotidine were studied on histamine-stimulated gastric Secretion in pylorus ligated intact rats at the dose levels. The data obtained showed that the efficacy of these drugs in reducing the volume of gastric juice was in the order of ranitidine> tiotidine> cimetidine. However, their acid reducing capacities were observed to be in the order of ranitidine> cimetidine> tiotidine in the checked doses. Thus, the data suggests that ranitidine is the most effective antiulcer drug of all the three tested H2-bloking agents

Effect of sucralfate on gastric bicarbonate secretion in patients with duodenal ulcer.

BACKGROUND: Sucralfate is known to protect gastroduodenal mucosa and thereby facilitate healing of peptic ulcer. The mechanism of action of this drug is still not fully known. METHODS: We studied the effect of sucralfate treatment on gastric bicarbonate secretion in 16 patients with duodenal ulcer. RESULTS: Sucralfate administration (3 g daily for 4 weeks) stimulated bicarbonate secretion from 3.1 +/- 1.2 mmol/h to 4.6 +/- 2.0 mmol/h (p < 0.05). Gastric juice volume as well as non-parietal volume secretion also increased significantly after sucralfate therapy (p < 0.05). CONCLUSION: Sucralfate causes stimulation of non-parietal volume-dependent gastric bicarbonate secretion.

Effect of pentagastrin on gastric bicarbonate secretion in patients with duodenal ulcer & healthy controls.

We studied the gastric acid and bicarbonate secretion rates in 12 patients with duodenal ulcer and 6 age matched healthy controls. Measurements of gastric juice volume (nonparietal and parietal), acidity and osmolality were done. The ulcer patients secreted more acid, parietal and nonparietal fluid than controls under basal conditions and after subcutaneous pentagastrin injection (6 micrograms/kg body weight). However, the gastric bicarbonate secretion was similar in the duodenal ulcer patients and controls, both under basal state as well as after pentagastrin stimulation. The gastric acidity was similar in ulcer patients and control subjects under both the states (49.3 +2- 4.5 vs 50.0 +/- 6.0 mmol/l basally, 85.2 +/- 8.9 vs 63.4 +/- 6.6 mmol/l after pentagastrin injection respectively). Thus, gastric bicarbonate secretion was similar, whereas parietal and nonparietal volume secretions were increased in patients with duodenal ulcer as compared to controls.

Ocimum sanctum Linn--a study on gastric ulceration and gastric secretion in rats.

The antiulcerogenic property of Ocimum sanctum Linn (Tulsi) was studied in pyloric ligated and pyloric ligated & aspirin treated rats. The extract of OSL reduced the ulcer index, free & total acidity on acute and chronic administration. Seven days pretreatment with the drug increased the mucous secretion also. It may be concluded that OSL extract has antiulcerogenic property against experimental ulcers, and it is due to its ability to reduce acid secretion and increase mucous secretion.

Effect of calcium on basal and stimulated gastric secretion

The role of extracellular calcium in the control of basal and stimulated gastric secretion was studied by using the Ca[++] channel blocker, verapamil. The volume of gastric secretion [in ml], free and total acidity [as unit%] and peptic activity [as unit/ml] were the parameters used to assess gastric function. All the drugs were given intraperitoneally every day for four successive days. The results demonstrated a stimulatory effect of prednisolone [25 mg/kg] and histamine [1 mg/kg] on gastric secretion. Verapamil [7 mg/kg] resulted in significant decrease in basal gastric secretion. Still, verapamil inhibited the stimulatory effect of prednisolone and histamine on basal gastric secretion. This inhibition was significantly more on prednisolone than histamine simulated gastric secretion, an interesting finding that needs further clarification. The mechanism of the inhibitory effect of verapamil could be through inhibiting the action of H[+] - K[+] ATPase enzyme or due to inhibiting transmembrane flux of Ca[++] ion which is necessary for the process of gastric secretion

Acute pancreatitis and reduction of H+ ion concentration in gastric secretions in experimental acute myocarditis produced by Indian red scorpion, Buthus tamulus, venom.

Crude venom (4 mg/kg) of scorpion (B. tamulus) was given in saline to anaesthetized dogs and rabbits. It produced a reduction in gastric H+ ion concentration in dogs with acute myocarditis. Simultaneously an increase in circulating amylase and lipase level was also observed. However 60% venom poisoned rabbits showed an elevated lipase level without a parallel increase in amylase. It is suggested that the venom acts directly on exocrine pancreas to cause acute pancreatitis.

Vagotomia seletiva: pH do suco gástrico / Selective vagotomy: gastric juice pH

Apresenta-se o resultado de um estudo de aferiçäo potenciométrica do pH do suco gástrico, em um grupo de 100 pacientes, masculino, com idade média de 34,68 anos, distribuídos da seguinte maneira: 25 voluntários, sem patologia do trato digestivo alto (controle); 25 portadores de UPD, submetidos à VSP e 50 com UPD, submetidos à VSA. O controle da variaçäo dos valores do pH foi executado no pré-operatório e no oitavo dia de pós-operatório, sendo em seguida repetido trimestralmente, até completar 12 meses. Observou-se uma forte correlaçäo entre à recorrência dos sintomas e/ou recidivas ulcerosas, quando se detectava precocemente, e níveis baixos de pH, em pacientes com VSP, enquanto que tal fenômeno näo foi verificado no grupo tratado com VSA. Relacionaram-se estes achados com a presença de inervaçäo vagal residual, associada à permanência do antrogástrico