The effect of citric acid and its sodium salts in test meals on the gastric outputs of acid and of chloride

Abstract

SUMMARYFive subjects were given 750 ml. test meals lasting 10-20 min, containing 0-300 mN citric acid, monosodium dihydrogen citrate, disodium monohydrogen citrate or trisodium citrate.1. Increase in concentration of sodium citrate in the range 0-125 mN gave increasing outputs of acid and chloride.2. The more acid the meal for any given citrate ion concentration, the less the output of acid and chloride.3. The greater the concentration of an acid citrate salt, the less the output of acid. 4. There was evidence of loss of acid from the stomach by diffusion with the more acid meals.

The Diagnostic Validity of Citric Acid‐Free, High Dose 13C‐Urea Breath Test After Helicobacter pylori Eradication in Korea

“…This finding suggests that citric acid has the ability to reduce pH at locations where H. pylori resides in the stomach [31]. Furthermore, previous studies [42][43][44][45][46] showed that citric acid retards gastric emptying; maximum slowing of gastric emptying was seen with citric acid and slowing became successively less as the three hydrogens were replaced with sodium [42,46]. Graham et al showed citric acid dose-dependently increased urease activity and breath 13 CO 2 activity, and reported that urease activity was markedly enhanced 10 min after administering urea in citric acid [31], which indicates that citric acid delays gastric emptying and enhances the intragastric distribution of urea.…”

“…This finding suggests that citric acid has the ability to reduce pH at locations where H. pylori resides in the stomach . Furthermore, previous studies showed that citric acid retards gastric emptying; maximum slowing of gastric emptying was seen with citric acid and slowing became successively less as the three hydrogens were replaced with sodium . Graham et al.…”

13C urea breath test (UBT) in the diagnosis of Helicobacter pylori: why does it work better with acid test meals?

“…In addition, ascorbic acid is a potent inhibitor of a variety of bacterial ureases, including H pylori urease. 29 Hence the dose dependent effect of citric acid can be explained by its increased buffering capacity and its ability to maintain a low pH in the bacterial environment 30 and perhaps also by its ability to cross the diffusional resistance of the gastric mucus at higher concentrations. 31 32 Pentagastrin injection increases gastric acid secretion but does not necessarily reduce pH at the site of bacterial colonisation.…”

Effect of Exercise on Gastric Emptying and Gastric Secretion

“…In recent experiments with citric acid and its sodium salts [8] it was found that a single receptor responding to acid could account for the observed inhibition of gastric emptying and of gastric secretion. Since in the present experiments high levels of exercise also have these actions, the question arises as to whether a single receptor system could account for both effects.…”