The effect of vagotomy on the inhibition of gastric secretion by intraduodenal fat

As, Ward

doi:10.1002/bjs.1800600710

Cited by 20 publications

(9 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The nature of a gastric inhibitory factor or factors released by high concentrations of glucose remains speculative. The response to 2-75 M glucose is similar to that observed after intraduodenal fat, both from a quantitative and a qualitative point of view and in both cases inhibition appears to persist after vagal section (Ward, 1973). It seems possible, therefore, that similar humoral factors are involved in both situations, though there is as yet no definite information on this point.…”

Section: Discussionsupporting

confidence: 65%

See 1 more Smart Citation

Effect of vagotomy on the gastric secretory response to intraduodenal osmotic agents in man.

Ward¹

1976

Gut

Self Cite

View full text Add to dashboard Cite

SUMMARY The effect of intraduodenal infusion of hypertonic saline and glucose on pentagastrinstimulated gastric secretion was investigated in 35 normal subjects, 32 duodenal ulcer patients, and 32 patients after truncal vagotomy and pyloroplasty. A significant gastric inhibitory response occurred after 0 51 M saline and 1-03 M glucose in the normal subjects and duodenal ulcer patients but after vagotomy there was no inhibition. This finding suggests that the inhibitory effect of these agents depends, at least in part, on a vagal reflex in man. The response to very high glucose concentrations persisted after vagotomy and it seems likely that a humoral mechanism may be involved in this situation.Intraduodenal infusion of hypertonic saline and glucose is known to inhibit gastric secretion both in animals (Matsuyama, 1932;Sircus, 1958) and in man (Shay et al., 1942b;Ward et al., 1969). The response has not been studied in detail, however, and little is known of the mechanisms mediating this inhibitory effect. The role of the vagus in particular requires definition and the present paper reports an investigation into this problem in man. MethodsThirty-five normal subjects (32 male; three female), 32 patients with chronic duodenal ulceration (30 male; two female), and 32 vagotomized subjects (29 male; three female) were studied. The mean ages were 42 years (22-59 years), 47 years (26-61 years), and 49 years (37-68 years). The normal subjects were volunteers awaiting minor inpatient surgery and all were free from gastrointestinal symptoms. The duodenal ulcer patients were awaiting gastric surgery and in all cases the nature of the pathology was confirmed at subsequent laparotomy. The vagotomized patients were tested six months or more after truncal vagotomy and pyloroplasty. Completeness of gastric vagal section was confirmed by a Hollander test before proceeding with the duodenal inhibitory test. The response to insulin was assessed on the basis of Hollander's original criteria (1948) as well as the additional criteria of subsequent

show abstract

Section: Discussionsupporting

confidence: 65%

“…Gastric inhibition was investigated using methods previously described (Ward, 1973). A fine polyvinyl tube was placed in the distal duodenum and a large bore sump tube positioned in the gastric antrum.…”

Section: Methodsmentioning

confidence: 99%

Effect of vagotomy on the gastric secretory response to intraduodenal osmotic agents in man.

Ward¹

1976

Gut

Self Cite

View full text Add to dashboard Cite

show abstract

“…A duodenal inhibitory test (Ward, 1973) was carried out on each of the normal subjects and duodenal ulcer patients. The gastric stimulus was an intravenous infusion of pentagastrin at a dose rate of 6 ,g/kg/hr.…”

Section: Methodsmentioning

confidence: 99%

The role of secretin in the inhibition of gastric secretion by intraduodenal acid

Ward¹,

Bloom²

1974

Gut

View full text Add to dashboard Cite

SUMMARY The effect of intraduodenal acid on pentagastrin-stimulated gastric secretion has been investigated in 12 normal subjects and 23 patients with chronic duodenal ulceration. Plasma secretin levels were monitored during each test using a highly sensitive radioimmunoassay.Significant inhibition of gastric secretion occurred in the normal subjects and duodenal ulcer patients. A significant rise in plasma secretin was observed in both groups after intraduodenal acid though there was a complete lack of correlation between the magnitude of the secretin response and the degree of gastric inhibition. Ten subjects received intraduodenal acid and a subsequent intravenous infusion of exogenous secretin (0.125-0.25 units/kg over six minutes). Gastric inhibition occurred after the acid instillation but not after secretin infusion despite plasma secretin levels greatly in excess of those produced by intraduodenal acid.These results suggest that release of secretin by itself cannot explain the gastric inhibitory response to intraduodenal acid in man.The presence of acid in the duodenum is known to inhibit gastric secretion both in animals (Pincus, Friedman, Thomas, and Rehfuss, 1944;Sircus, 1958) and in man (Shay, Gershon-Cohen, and Fels, 1942;Johnston and Duthie, 1964). The mechanism of this response is, however, uncertain. The main possibilities (which may of course interact) appear to be either a vagal reflex or a humoral response particularly involving secretin. The evidence for each of these views is fully discussed elsewhere (Ward, 1974). The role of the vagus has been examined in detail and it appears likely that gastric inhibition is dependent on a vagal reflex in man (Ward, 1974). Strong claims, however, have been made that in dogs secretin is the mediator of gastric inhibition by intraduodenal acid (Johnson and Grossman, 1968) and the present study was therefore undertaken to examine the response with particular emphasis on the role of secretin. Materials and MethodsThe response to intraduodenal acid was investigated in 35 patients, 10 of whom also received an intravenous secretin infusion. There were 12 normal subjects (Orm, 2f) and 23 patients (21m, 2f) with chronic duodenal ulceration. The average age of Received for publication 10 July 1974. the normal subjects was 38 years (range 21-63) and their average weight 71 kg (range 55-83 kg). These subjects were awaiting minor inpatient surgery and all were free of gastrointestinal symptoms. The duodenal ulcer patients were awaiting gastric surgery and in all cases the pathology was confirmed subsequently at laparotomy. Their average age was 42 years (range 27-67) and their average weight 68 kg (range 52-82 kg).A duodenal inhibitory test (Ward, 1973) was carried out on each of the normal subjects and duodenal ulcer patients. The gastric stimulus was an intravenous infusion of pentagastrin at a dose rate of 6 ,g/kg/hr. Gastric samples were collected at 10-minute intervals throughout the test.Once a secretory plateau had been reached 40 ml of 0O1N hydrochloric acid ...

show abstract

“…It has been questioned whether fat in the duodenum inhibits gastric acid secre tion by a nonvagal mechanism in man [8,11], but a recent study in rats strongly suggests that the inhibitory action of oleic acid is mainly mediated by circulating secretin [12], In the present study, an increment of 1.3 ± 0.4 pA/ in plasma secretin corresponds with the 21 % inhibition of acid secretion, whereas in another study from our laboratory with exog enous secretin (and an identical pentagastrin dose) a twofold increment of 3.1 ± 0.9 pM also inhibited acid output by approximately 21% [13]. The difference between the two increments were not significant (p = 0.05, Mann-Whitney U test).…”

Section: Discussionmentioning

confidence: 99%

Fat and Gastric Acid Secretion

Petersen¹,

Olsen²,

Jepsen³

et al. 1992

Digestion

View full text Add to dashboard Cite

To evaluate the importance of the terminal carboxyl group of the oleic acid molecule in the inhibition of gastric acid secretion, 6 normal persons were stimulated twice with duodenal perfusates containing either 20 mM oleic acid or 20 mM oleyl alcohol. Oleic acid significantly inhibited the gastric acid secretion stimulated by pentagastrin (100 ng/kg/h) and increased the levels of secretin in plasma. The effect of oleyl alcohol was insignificant. It is concluded that the carboxyl group of the fat molecule has an important role in the inhibition of gastric acid secretion, and the effect could in part be attributable to the release of secretin into plasma.

show abstract

The effect of vagotomy on the inhibition of gastric secretion by intraduodenal fat

Cited by 20 publications

References 26 publications

Effect of vagotomy on the gastric secretory response to intraduodenal osmotic agents in man.

Effect of vagotomy on the gastric secretory response to intraduodenal osmotic agents in man.

The role of secretin in the inhibition of gastric secretion by intraduodenal acid

Fat and Gastric Acid Secretion

Contact Info

Product

Resources

About