Assessment of Intragastric Acidity in Man: Modern Aspects, Reproducibility of Intragastric pH-Monitoring, and Pharmacodynamic Results Obtained with H<sub>2</sub>-Receptor Antagonists

Merki, H. S.; Witzel, L; Kaufmann, Damian; Kempf, Marie; Muessig, V; Neumann, Joyce; Scheurle, E; Roehmel, Jobst; Walt, R P

doi:10.3109/00365528809099140

Cited by 12 publications

(10 citation statements)

References 21 publications

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“…It has to be realized that the gastric acidity does not necessarily correlate with the gastric acid secretion, since gastric acidity is the complex end-result of buffering by food and drinks, swallowed saliva, gastric acid secretion, mucosal bicarbonate secretion, gastric emptying and duodenogastric reflux (5). Continuous ambulatory pH recordings show a good day-to-day reproducibility and small changes in intragastric acidity as well high-frequency pH fluctuations are readily detectable (7,8,19,24). In addition, this technique is well tolerated by patients and healthy volunteers.…”

Section: Gastric Acid Secretion and Gastric Aciditymentioning

confidence: 97%

“…The development of reliable miniature pH electrodes, data loggers with sufficient memory capacity and user-friendly computer programs for the analysis has made it possible to record intragastric pH during a prolonged period in an ambulant setting (8,(15)(16)(17)(18)(19)(20). However, this technique is not suitable for quantifying gastric acid secretion or for determining the chemical composition of the gastric juice.…”

Section: Gastric Acid Secretion and Gastric Aciditymentioning

confidence: 98%

“…Various types of electrodes to measure intraluminal pH are commercially available; a glass electrode with skin reference, a combined glass electrode with built-in reference electrode, a combined glass telemetry capsule, a unipolar monocrystalline antimony electrode with a skin reference, and the recently developed ion-sensitive field effect transistor (ISFET) electrode (20,25). At present, most studies on intragastric pH are performed using either glass or antimony electrodes (9).…”

Section: Technical Aspectsmentioning

confidence: 99%

“…Unfortunately, all aspiration techniques are cumbersome, laborious and inconvenient for the patient, and for these reasons ambulatory and/or prolonged measurements are difficult to perform (7)(8)(9).…”

Section: Gastric Acid Secretion and Gastric Aciditymentioning

confidence: 99%

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24-h Recording of Intragastric pH: Technical Aspects and Clinical Relevance

Herwaarden¹,

Samsom²,

Smout³

1999

Scandinavian Journal of Gastroenterology

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van Herwaarden MA, Samsom M, Smout AJPM. 24-h recording of intragastric pH: technical aspects and clinical relevance. Scand J Gastroenterol 1999;34 Suppl 230:9-16.Background: Information about gastric acid secretion and gastric acidity can be obtained using several techniques but, presently, continuous intragastric pH recording is probably the one applied most frequently. This paper aims to review the technical aspects and some important applications of intragastric pH monitoring in research and clinical practice. Methods: Literature review. Results: Most studies on intragastric pH are performed with either glass or antimony electrodes. Optimal measurement of 24-h intragastric pH requires accurate calibration of the pH measuring system, exact positioning of the pH electrodes, and a sufficient sample rate. Depending on the aim of the study the results of intragastric pH monitoring are expressed either as median H activity or as median pH values. Gastric acidity shows a circadian rhythm, modified by buffering meals and nocturnal duodenogastric reflux. In health, age, gender and smoking habits are known to influence gastric acidity. In duodenal ulcer disease an increased gastric acidity is found and in patients with gastric ulcer gastric acidity is decreased. In GERD, no relation between reflux oesophagitis and gastric acidity is found. Helicobacter pylori affects intragastric pH most pronounced during acid inhibitory therapy, both in DU patients and in healthy subjects. In the absence of H. pylori the effect of proton-pump inhibitors on intragastric pH is much less than in the presence of the microorganism, whereas the effect of ranitidine on intragastric pH is barely affected by the H. pylori status. Conclusions: Despite some limitations, intragastric pH monitoring provides important information about gastric acidity.

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Section: Gastric Acid Secretion and Gastric Aciditymentioning

confidence: 97%

Section: Gastric Acid Secretion and Gastric Aciditymentioning

confidence: 98%

Section: Technical Aspectsmentioning

confidence: 99%

Section: Gastric Acid Secretion and Gastric Aciditymentioning

confidence: 99%

See 2 more Smart Citations

24-h Recording of Intragastric pH: Technical Aspects and Clinical Relevance

Herwaarden¹,

Samsom²,

Smout³

1999

Scandinavian Journal of Gastroenterology

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“…It is assumed that the aspiration method has several shortcomings (table 1) [ 15]. Most of these, however, are purely speculative.…”

Section: Are There Shortcomings Of the Gastric Aspiration Method?mentioning

confidence: 99%

Gastric Aspiration Technique for pH Recording: A Critical Evaluation of This Method

Dammann

Dreyer²,

Kangah³

et al. 1990

Dig Dis

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The most often used methods for the measurement of intragastric acidity are repeated mostly hourly aspirations of gastric contents or continuous pH measuring with an electrode. Intragastric pH, volume of aspirated gastric juice and total acid secretion have been tested over relatively short periods of time (2-12 h) and through an entire 24-hour period. Nearly every clinical antiulcer drug which neutralizes acidity or inhibits acid secretion has been investigated with this method. pH monitoring with the gastric aspiration procedure is a reliable and reproducible method. There is a remarkable global agreement in the results. While pH electrodes provide an alternative means of measuring pH, they have the disadvantage of not allowing measurement of volume and/or acid secretion.

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Role of Calcium Carbonate Administration Timing in Relation to Food Intake on Its Efficiency in Controlling Hyperphosphatemia in Patients on Maintenance Dialysis

et al. 1998

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A study has claimed that at an equal elemental calcium dose, CaCO3 was not less but equally as efficient in controlling predialysis hyperphosphatemia as calcium acetate, provided both calcium salts were ingested 5 min before meals instead of during meals because the higher acidity of the fasting gastric juice would allow for better dissociation of CaCO3. However, this study did not directly demonstrate that the efficiency of CaCO3 in controlling hyperphosphatemia was actually greater when it was administered before a meal than during a meal. To examine this point, we performed a 3 month randomized crossover trial in 12 reliable and stable patients maintained on chronic hemodialysis. Their plasma concentrations of calcium, protein, phosphate, bicarbonate, urea, and creatinine were measured before the first dialysis of each week and the amount of intact parathyroid hormone (PTH) at the beginning and at the end of each of the 3 months. Comparison of the plasma concentrations measured during the 2 modes of administration showed no significant differences in creatinine, urea, bicarbonate, or intact PTH. The mean (+/-SD) plasma concentration of PO4 was not significantly lower (1.88+/-0.50 vs. 1.74+/-0.41 mM) whereas the corrected level of plasma Ca was significantly lower (2.30+/-0.17 vs. 2.38+/-0.16 mM; p < 0.04) when CaCO3 was given before meals than during meals. In conclusion, the administration of CaCO3 before a meal does not increase its efficiency in controlling hyperphosphatemia because the level of plasma PO4 was actually slightly higher with this timing of administration whereas the comparison of the creatinine and urea levels suggested a stability of phosphate intake and the comparison of the PTH and bicarbonate levels suggested the stability of osteolysis and of the transcellular membrane shift of phosphate. Also, administration of CaCO3 before a meal is associated with significantly lower plasma corrected calcium, suggesting less absorption of calcium, which may be an advantage but only in hypercalcemic patients. There is no reason other than the prevention of its hypercalcemic effect to recommend the administration of CaCO3 just before meals rather than during meals.

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Assessment of Intragastric Acidity in Man: Modern Aspects, Reproducibility of Intragastric pH-Monitoring, and Pharmacodynamic Results Obtained with H₂-Receptor Antagonists

Cited by 12 publications

References 21 publications

24-h Recording of Intragastric pH: Technical Aspects and Clinical Relevance

24-h Recording of Intragastric pH: Technical Aspects and Clinical Relevance

Gastric Aspiration Technique for pH Recording: A Critical Evaluation of This Method

Role of Calcium Carbonate Administration Timing in Relation to Food Intake on Its Efficiency in Controlling Hyperphosphatemia in Patients on Maintenance Dialysis

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Assessment of Intragastric Acidity in Man: Modern Aspects, Reproducibility of Intragastric pH-Monitoring, and Pharmacodynamic Results Obtained with H2-Receptor Antagonists

Cited by 12 publications

References 21 publications

24-h Recording of Intragastric pH: Technical Aspects and Clinical Relevance

24-h Recording of Intragastric pH: Technical Aspects and Clinical Relevance

Gastric Aspiration Technique for pH Recording: A Critical Evaluation of This Method

Role of Calcium Carbonate Administration Timing in Relation to Food Intake on Its Efficiency in Controlling Hyperphosphatemia in Patients on Maintenance Dialysis

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Product

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Assessment of Intragastric Acidity in Man: Modern Aspects, Reproducibility of Intragastric pH-Monitoring, and Pharmacodynamic Results Obtained with H₂-Receptor Antagonists