The effect of highly selective vagotomy on the relationship between gastric mucosal blood flow and acid secretion in man

Knight, S E; McIsaac, R L; Fielding, L P

doi:10.1002/bjs.1800651014

Cited by 12 publications

(6 citation statements)

References 7 publications

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“…This was again observed 2 months after the operation when betazole stimulated gastric mucosal blood flow without stimulating a corresponding increase in acid secretion. Similar studies have been done in man by Knight et al [1] who also found the different effects of highly selective vagotomy on gastric mucosal blood flow and acid secretion. These investigators showed that patients with duodenal ulcer disease had a lower ratio between gastric mucosal blood flow and acid secretion (during pentagastrin stimulation) than was found in normal subjects.…”

Section: Invited Commentarysupporting

confidence: 82%

Invited commentary

Cheung

1981

World j. surg.

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Section: Invited Commentarysupporting

confidence: 82%

Invited commentary

Cheung

1981

World j. surg.

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“…In addition to these factors, there are others that may play a part in the genesis of these lesions; some are genetic, such as increased serum pepsinogen I [2] and some are environmental, such as smoking or alcohol ingestion [2]. In our previously reported studies, we have shown that 2 elements, acid and blood flow, are clearly related in the normal stomach and that this association is different in duodenal ulcer [4] but returns to normal after highly selective vagotomy [5].…”

mentioning

confidence: 99%

Basal and dose‐response studies of gastric mucosal blood flow: Comparison of duodenal ulcer patients before and after highly selective vagotomy with normal volunteers

et al. 1982

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Gastric mucosal blood flow (neutral red clearance, NRC) and acid secretion were measured before and after highly selective vagotomy (HSV). Eleven patients with duodenal ulcer were studied before and 12–21 days after HSV. Eight volunteers were also studied using the histamine‐H2‐receptor antagonists cimetidine and ranitidine. Basal secretion was collected for 40–50 minutes and pentagastrin was given in increasing doses each for 40 minutes. Data were analyzed using Wilcoxon's signed‐ranks test for paired samples and an analysis of covariance. Basal NRC was similar both for patients and for volunteers and was unaffected by HSV. There was a linear correlation between NRC and acid output. The patients with duodenal ulcer had a lower ratio of NRC to acid during pentagastrin stimulation than was found in normal subjects, but the regression line after HSV was comparable to that found for the volunteers. Although stimulated acid output was reduced by HSV, NRC was significantly higher after HSV than before. The 2 histamine‐H2‐receptor antagonists reduced both NRC and acid to a similar extent, and this could not be overcome by increasing the dose of pentagastrin. These results indicate that mucosal blood flow and acid secretion may not be unconditionally linked, although a linear relationship was always found. HSV produces an effect on blood flow that is not linked to the reduction in acid output.

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“…[12][13][14] The following limitations of the method must be taken 16 neutral red, like aminopyrine, initially accumulates in the parietal cells and is consecutively washed out into the gastric lumen by the acid secretion. This explains the initial decline of the neutral red concentration in the gastric juice and the corresponding behaviour of the clearance and the R-value (Fig.…”

Section: Discussionmentioning

confidence: 99%

Effect of nicotine on gastric mucosal blood flow and acid secretion.

Sonnenberg¹,

Hüsmert²

1982

Gut

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SUMMARY The effects of an intravenous infusion of nicotine at a dose of 2.5, 5.0, 7*5, or 100 ,g kg-'h-' on pentagastrin-stimulated gastric mucosal blood flow and acid secretion were investigated in eight healthy male non-smokers. Each dose was tested in two males. Gastric neutral red clearance served as a measure of mucosal blood flow. Nicotine reduced volume secretion, acid secretion, and neutral red clearance in a dose dependent manner. In five healthy male smokers smokinf of five cigarettes per two hours induced similar changes to the intravenous infusion of 5 ,ug kg7 h71 nicotine. As volume secretion was inhibited more than neutral red clearance, it is concluded that nicotine increases blood supply to the gastric mucosa relatively to the reduced gastric secretion. Nicotine is either not associated with the development of peptic ulcers, or it exerts its ulcerogenic action via other mechanisms than change of acid secretion and gastric mucosal blood flow.Gastric and duodenal ulcers occur more frequently in smokers than in non-smokers.' 2 Peptic ulcers heal less well in smokers than in non-smokers.3?6 Since the work of Virchow, decreased mucosal blood flow has been thought to be one of the factors responsible for the loss of mucosal integrity in the upper gastrointestinal tract.7 8 In the following study the effects of intravenous nicotine infusion on gastric mucosal blood flow and acid secretion were investigated.Methods

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The effect of highly selective vagotomy on the relationship between gastric mucosal blood flow and acid secretion in man

Cited by 12 publications

References 7 publications

Invited commentary

Invited commentary

Basal and dose‐response studies of gastric mucosal blood flow: Comparison of duodenal ulcer patients before and after highly selective vagotomy with normal volunteers

Effect of nicotine on gastric mucosal blood flow and acid secretion.

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