Achlorhydria With a Review of 210 Cases in Patients With Gastrointestinal Complaints

Bockus, Henry L.; Bank, Joseph; Willard, John H.

doi:10.1097/00000441-193208000-00004

Cited by 25 publications

(2 citation statements)

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“…As to the relation of acid and pepsin secretion into the gastric lumen, the results shown in Fig. 8 support the report by Bockus et al (1932) mentioned above and show cases of anacidity which still preserve the secretion of pepsin. This finding was further extended in the present study, namely, by the comparison of the maximal free acidity in native gastric juice with the proteolytic activity of urine at pH 1.5 as shown in Fig.…”

Section: Discussionsupporting

confidence: 86%

“…To discuss the influence upon gastric secretion of chronic gastritis which is known to appear in high frequency in the remnant of the stomach after surgery (Palmer 1954, Debray et al 1956), the consideration should be paid to the difference in the susceptibility among various types of secretory cells of the stomach. (Doig et al 1951, Poliner & Spiro 1958, Glass et al 1960) Bockus et al (1932) pointed out already that the absence of pepsin secretion always means the absence of acid secretion, while pepsin can be secreted without accompanying acid secretion. The result shown in Fig.…”

Section: Discussionmentioning

confidence: 99%

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Gastrectomy and Secretory Function of the Stomach

Ishimori

Sakurada

Yamagata

1972

Tohoku J. Exp. Med.

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-The secretory function of the remnant of the resected stomach together with the proteolytic activity of urine was compared among various types of gastrectomy in reference to the site and the degree of resection and to atrophic gastritis in the remnant. The surgical removal of pyloric antrum was found to lower or lose the proteolytic activity of gastric juice at pH 3.5 or higher, but not of urine. Atrophic gastritis in the remnant of the resected stomach was also found to influence the acid and protease secretion of the stomach in the parallel manner, but this is less clearly seen in the proteolytic activity of urine. The step-wise dissociation between acid and protease secretion and between synthesis and secretion of protease was demonstrated as the characteristic feature of the functional disturbance of the stomach due to atrophic gastritis. Namely, the abolition of acid secretion precedes that of pepsinogen secretion and then pepsinogen continues to be synthesized and excreted into urine after the cessation of its secretion into the gastric lumen. The difference of the inborn resisting capacity among different types of secretory cells was suggested as an important contributing factor. The importance of the simultaneous measurement of the gastric and urinary proteolytic activity was stressed in order to evaluate the histologic and functional status of gastric mucosa precisely.The secreting secretory cell mass was proposed to represent reasonably the gastric secretory response obtained by the maximal stimulation. -gastric secretion; pepsin; uropepsin; gastrectomy ; atrophic gastritis In relation to the various nutritional disturbances appearing after gastrectomy, the influence of the surgical removal of gastric mucosa and gastritis known to appear in high frequency in the remnant of the resected stomach upon the secretory function of the stomach has attracted attention of many investigators. It has been also shown that there is the dissociation among parietal cell, peptic cell and intrinsic factor secreting cell as to the degree of functional disturbance during the course of the various types of mucosal damage including gastritis (Doig et at. 1951, Poliner and Spiro 1958, Glass, et al. 1960.According to the recent reports (Seijffers et al. 1963, Kushner et al. 1964, Samloff 1969 it has been well established that the stomach elaborates several pepsinogens and their distribution on gastric mucosa differs from each other. It is the purpose of the present investigation to re-evaluate the influence of the surgical removal of Received for publication, July 21, 1971.

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Gastrectomy and Secretory Function of the Stomach

Ishimori

Sakurada

Yamagata

1972

Tohoku J. Exp. Med.

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Histamine Test Meals

Polland¹

1933

Arch Intern Med (Chic)

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Gastric Acidity in Thyroid Dysfunction

Wilkinson¹

1933

JAMA

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in some cases there is an absence of hydrochloric acid.Hardt1 in 1916 called attention to the fact that thyroid feeding caused lowered gastric acidity in normal dogs. Barker 2 in 1918 mentioned hypochlorhydria, and King 3 in 1919 noted that achlorhydria and achylia occur in hyperthyroidism. Lockwood 4 in 1925 and Moll and Scott5 in 1927 reported a high incidence of achlorhydria in exophthalmic goiter. Following this line of thought, Truesdell 6 in 1926 showed that a lowering of acidity could be produced regularly by feeding thyroid to dogs, and in some achlorhydria was produced.On the other hand, Crile 7 and his co-workers have held that the same mechanism that produced hyperthyroidism could in some cases produce peptic ulcer.He has also stated that denervation of the suprarenals and a hemithyroidectomy frequently relieves recurrent peptic ulcer. If this theory is true, hyperthyroidism should raise, not lower, the gastric acidity. Lerman and Means8 have shown, however, that there is a defi¬ nite tendency to lowered gastric acidity in hyperthy¬ roidism and that the proportion of achlorhydria is increased beyond the normal.This study was undertaken to show the relationship between hyperthyroidism and gastric acidity and to determine to what extent the acid returned to its nor¬ mal level after relief of the toxicity. Also, we wanted to see what effect a postoperative lowering of the basal metabolic rate below the normal level would have on gastric acid. This study comprises the results of gastric analyses in 100 cases of hyperthyroidism, taken before opera¬ tion. At the Lahey Clinic it is the practice to have all patients return three months after partial thyroidectomy for a check-up metabolism. Of the original 100 cases, we were able to get only about one half back for check-up gastric studies. This was due partly to the reluctance of some patients to have a second test, partly to inability to return, and partly to the fact that three months has not elapsed since some of the original tests were made. It was felt, however, that for purposes of averages, a comparable number of postoperative check¬ ups would give as much information. Consequently, determinations were made in 114 cases. In addition.

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Achlorhydria With a Review of 210 Cases in Patients With Gastrointestinal Complaints

Cited by 25 publications

References 0 publications

Gastrectomy and Secretory Function of the Stomach

Gastrectomy and Secretory Function of the Stomach

Histamine Test Meals

Gastric Acidity in Thyroid Dysfunction

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