Relationship between changes in plasma gastrin and lower oesophageal sphincter pressure after meals

McCall, Iain W.; Harvey, Richard F.; Owens, Caroline; Clendinnen, B G

doi:10.1002/bjs.1800620105

Cited by 21 publications

(13 citation statements)

References 11 publications

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“…Nevertheless, changes 102 secondary effects on gastrin release, and gastrin concentrations were measured during cimetidine infusion in the present studies. The role of gastrin as a physiological determinant of LOS pressure is now in debate, and the recent studies of Dent and Hansky (1976) and our own unpublished data, have failed to confirm earlier suggestions that gastrin is involved in LOS control (Giles et al, 1969;Castell and Harris, 1970;McCall et al, 1975). In any event, mean serum gastrin concentrations did not show any statistically significant variation from basal values (Fig.…”

Section: Discussionmentioning

confidence: 57%

Effect of cimetidine on the human lower oesophageal sphincter.

Osborne¹,

Lennon²,

Henderson³

et al. 1977

Gut

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SUMMARY Lower oesophageal sphincter pressures in healthy volunteers were measured by a rapid pull-through technique during intravenous infusion of the histamine H2-receptor antagonist, cimetidine. No consistent effects on sphincter pressure were observed which are liable to be of clinical importance. Serum gastrin concentrations during cimetidine infusion were measured by radioimmunoassay and showed no significant variation. In a further series of experiments, the response of the lower oesophageal sphincter to intravenous bolus injection of pentagastrin was measured before and during cimetidine infusion. Cimetidine infusion had no significant effect on the sphincter response to pentagastrin.

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Section: Discussionmentioning

confidence: 57%

Effect of cimetidine on the human lower oesophageal sphincter.

Osborne¹,

Lennon²,

Henderson³

et al. 1977

Gut

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“…It also suggests that the rise in LESP after the protein solution could be independent of its protein content and due to some factor common to the two solutions. McCall et al (1975) used a similar though lower molarity protein solution, but did not use a control. Their conclusion that the pressure rise they obtained, which was very similar to this study, was mediated by gastrin is invalid, since it relies on the assumption that gastrin release was the only way in which the solution could affect LESP.…”

Section: Discussionmentioning

confidence: 99%

Relationship of serum gastrin response to lower oesophageal sphincter pressure.

Dent¹,

Hansky²

1976

Gut

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Exogenous gastrin is a powerful stimulant of lower oesophageal sphincter (LES) contraction (Giles et al., 1969). Castell and Harris (1970) proposed that endogenous gastrin is a major controller of basal lower oesophageal sphincter pressure (LESP) on the basis of observed LESP changes with alteration of intragastric pH. Changes in circulating gastrin with pH manipulation were assumed in this study, as they were with protein feeding experiments in man in which a rise in LESP occurred after feeding (Nebel and Castell, 1972;Lipshutz et al., 1973;Roszkowski et al., 1973).Closer examination of this theory with gastrin radioimmunoassay has not supported gastrin as the mediator of the gastric pH dependent LESP changes (Higgs et al., 1974 MethodsNineteen normal healthy volunteers, 14 men and five women of mean age 21 years were studied after a minimum fast of five hours.The manometric catheter was passed orally or nasally after spray anaesthetization of the oropharynx with 3 ml 2% lignocaine. The subject then

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“…Similarly, many of the studies reporting a rise in LOS pressure after protein feeding (Nebel and Castell, 1972;Lipshutz et al, 1973;Roszkowski et al, 1973) have assumed rather than demonstrated an effect on circulating gastrin levels. In studies which have included serum gastrin determinations there has been a varied temporal relationship between administration of the stimulus to gastrin release, the peak gastrin response, and the change in LOS pressure (Higgs et al, 1974;McCall et al, 1975;Dent and Hansky, 1976). Furthermore, while Dent and Hansky (1976) report a rise in LOS pressure 30 minutes after the peak gastrin response to protein instillation, a similar rise was observed after intragastric instillation of a control solution of saline, this time without accompanying variation in the serum gastrin concentrations.…”

Section: -mentioning

confidence: 99%

“…There is no doubt that exogenous gastrin increases sphincter pressure (Giles et al, 1969;Cohen and Lipshutz, 1971;Trindade et al, 1975;Kaye et al, 1976) but the evidence that endogenous gastrin is a physiological determinant of sphincter pressure is less convincing (Grossman, 1973;Roszkowski et al, 1973;Farrell et al, 1974;McCall et al, 1975;Dodds et al, 1975a, b;Dent and Hansky, 1976). Central to the controversy is the methodology of LOS pressure measurement.…”

mentioning

confidence: 99%

Lower oesophageal sphincter response to gastrin--pharmacological or physiological?

Henderson¹,

Lidgard²,

Osborne³

et al. 1978

Gut

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SUMMARY The response of the lower oesophageal sphincter (LOS) to intragastric instillation of protein was assessed in 10 healthy volunteers. Sphincter pressures were measured by a rapid pullthrough technique and serum gastrin concentrations during each test were determined by radioimmunoassay. Despite stimulation of gastrin release by protein instillation, no significant change in LOS pressure was observed. However, intravenous pentagastrin (0 25 and 0.5 jig/kg) produced an immediate increase in sphincter pressure, which then returned to the basal level within four minutes. Thus, although pentagastrin is an effective pharmacological stimulant of the sphincter, endogenous gastrin appears not to be a physiological determinant of LOS pressure in man.The role of endogenous gastrin in control of the lower oesophageal sphincter (LOS) is still a subject of controversy. There is no doubt that exogenous gastrin increases sphincter pressure (Giles et al., 1969;Cohen and Lipshutz, 1971;Trindade et al., 1975;Kaye et al., 1976) but the evidence that endogenous gastrin is a physiological determinant of sphincter pressure is less convincing (Grossman, 1973;Roszkowski et al., 1973;Farrell et al., 1974;McCall et al., 1975; Dodds et al., 1975a, b;Dent and Hansky, 1976). Central to the controversy is the methodology of LOS pressure measurement. Most studies have used static pressure recording catheters or a station pull-through technique in which the recording catheter is withdrawn across the sphincter in 1 cm steps, pausing after each step to record LOS pressure during three or four respiratory cycles. Rapid pull-through techniques are now available which minimise error in pressure recording (Dodds etal., 1975a(Dodds etal., , b 1976) and a rapid pull-through method was used in the present study to measure the LOS pressure response to endogenous gastrin release provoked by intragastric instillation of protein. Methods TECHNIQUE OF LOS PRESSURE MEASUREMENT LOS pressure was measured by a rapid pull-through technique based on that described by WaldeckReceived for publication 9 August 1977 (1972) and modified by Osborne and his colleagues (1977). Recordings were made with a single lumen polyvinyl tube which was perfused at 6 ml/min as it was withdrawn across the LOS at 0'9 cm/s. This system was capable of recording a pressure rise rate of 70 mmHg/s when tested on the bench. By convention, LOS pressure is measured as the peak height of the profile relative to intragastric pressure. RESPONSE OF LOS TO PENTAGASTRINFour healthy male volunteers (aged 26-32 years), without a previous history of dyspepsia, were given graded doses of pentagastrin (Peptavlon, ICI) to determine the LOS pressure response. Doses of 0'0625, 0 125, 0-25, and 0 5 jig/kg were used, the pentagastrin being diluted in 10 ml/150 mm sodium chloride solution and injected intravenously over 60 seconds. The four doses were given in a random order which was not known to the subject. LOS pressure was measured every two minutes for 10 minutes before pentagastrin injectio...

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Relationship between changes in plasma gastrin and lower oesophageal sphincter pressure after meals

Cited by 21 publications

References 11 publications

Effect of cimetidine on the human lower oesophageal sphincter.

Effect of cimetidine on the human lower oesophageal sphincter.

Relationship of serum gastrin response to lower oesophageal sphincter pressure.

Lower oesophageal sphincter response to gastrin--pharmacological or physiological?

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