The Normal Range of Gastric Acidity From Youth to Old Age

The study of gastric pepsin has failed to receive adequate consideration for several reasons, but mainly because of the lack of technic for obtaining reliable measurements. We investigated the method originally proposed by Gates (1) and more fully elaborated by Gilman and Cowgill (2), and found it to be accurate and highly satisfactory. In fact, it is more accurate than is needed in clinical practice. We have used this method, with slight modifications, in the investigations reported in this and the following paper. The details of the technic can be obtained from the original article by Gilman and Cowgill (2). In this method one measures the rate of digestion of gelatin from an exposed and developed photographic film. As digestion proceeds, the silver granules in the gelatin are liberated, and the resulting decrease in opacity of the film is taken as a measure of the digestion which has occurred. TECHNICWe use, for the digestion, a cell 11 mm. in diameter and 1.2 mm. in depth turned out of sheet bakelite on a lathe. Its capacity is approximately 0.5 cc. The solution to be tested, diluted with an equal volume of glycine hydrochloric acid buffer of pH 2, is placed in the cell. A small square of the prepared film is then laid over the top of the cell and this is covered by a glass square. The whole is clamped together by means of a spring clothes pin and placed in a water bath the temperature of which is maintained at 250 C. After fifteen minutes the film is removed, washed, and dried, and the change in opacity is determined with a colorimeter. The standard for comparison is a freshly prepared suspension of colloidal silver. The index of peptic digestion is obtained by the use of a nomogram as described by Gilman and Cowgill (2).

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“…This is in accord with the higher acidity in males which has previously been demonstrated (3). Although …”

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confidence: 91%

Studies of Gastric Pepsin. I. Methods of Measurement and Factors Which Influence It

Osterberg¹,

Vanzant²,

Alvarez³

1933

J. Clin. Invest.

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“…Achlorhydria was demonstrated in sixty-eight per cent of fifty cases, an incidence five times that in normal individuals of the same age (17). This is a definitely higher figure than most investigators have reported (5,7,8,10) and is more nearly comparable to that found by Herzfeld (6) and Moore (11).…”

Section: Methodsmentioning

confidence: 43%

“…) On the basis of these four factors there is no significant difference between those patients in whom gastric acidity returned to normal and those with a persisting achlorhydria. Excluding the eight patients not followed and the two in whom the persisting anacidity may still be associated with a continuation of thyroid disease, there is an incidence of achlorhydria for the group of ten per cent which is not higher than the incidence for normal individuals in this age group (17,18). 49 The results of this study clearly indicate that the gastric acidity in hyperthyroidism is markedly diminished.…”

Section: Methodsmentioning

confidence: 63%

A Study of the Gastric Secretion in Hyperthyroidism Before and After Operation

Berryhill¹,

Williams²

1932

J. Clin. Invest.

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Gastric symptoms have long been associated with hyperthyroidism. The reports of studies attempting to correlate these symptoms with disturbances in gastric secretions are not uniform. Several investigators (I, 2) report an increase in the hydrochloric acid and total volume of secretion. One (3) contends there is no characteristic secretion in exophthalmic goiter. A greater number (4-16) report a diminution or absence of hydrochloric acid in hyperthyroidism and in the feeding of thyroid extracts to animals. Excellent reviews of the subject have appeared in recent papers by Moll and Flint (9), Brown (10), and Lerman and Means (13). With the development of a more accurate method for determining the degree of gastric acidity by histamine stimulation it seemed desirable to restudy the problem. Accordingly, a survey was begun eighteen months ago to determine the behavior of gastric secretion in hyperthyroidism before and after operation. Since the beginning of this work, Lerman and Means (13) have reported a study of gastric secretion in exophthalmic goiter before treatment using a similar method. METHODThe present generally accepted technique of gastric analysis was employed in this study. A fasting specimen was withdrawn, followed by the ingestion of 50 cc. of 7 per cent alcohol. Specimens were removed at twenty and forty minute intervals. If the last specimen contained no hydrochloric acid, histamine (ergotamine acid phosphate) 0.1 mgm. per ten kilograms was given subcutaneously and specimens were withdrawn at twenty and forty minute intervals. The volume, free hydrochloric acid and total acidity of each specimen were determined. T6pfer's reagent and phenolphthalein respectively were used as indicators and the results expressed as the number of cc. of N/1O NaOH necessary to neutralize 100 cc. of gastric juice.Two analyses were done on each patient before preoperative iodine therapy was begun, a third the day before operation, and a fourth the day of discharge. The patients were followed by subsequent analyses at intervals of one to two months. We have arbitrarily classified the results upon the basis of the highest acid content obtained after the stimulation by alcohol and histamine: (1) Normals, those patients in whom repeated analyses showed free hydrochloric 753

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“…In previous papers we (1) and others (2) have shown that gastric secretion decreases with advancing years. This finding, however, has been based on averages of many examinations in different people and no accurate information is available as to what happens in the individual.…”

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confidence: 71%

The Decrease of Gastric Secretion With Advancing Years: Further Observations

Bloomfield¹

1940

J. Clin. Invest.

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In previous papers we (1) and others (2) have shown that gastric secretion decreases with advancing years. This finding, however, has been based on averages of many examinations in different people and no accurate information is available as to what happens in the individual. Does a gradual decline of secretion take place in everyone or do some people undergo an abrupt defection, while others preserve their gastric juice unchanged into old age? In the attempt to answer these questions we previously reported the results of standard histamine tests repeated in the same individuals after an interval of five years (3). The findings were of interest but, unfortunately, the five-year period appears to have been too brief to yield conclusive results. Recently it has been possible to re-examine five essentially normal people whose gastric secretions were explored over ten years ago. The data from these tests, which seem much more significant than those of the previous series, are herewith presented. PROCEDUREThe procedure was as far as possible a duplication of the original examination. The subjects were in the ward overnight and were under basal conditions. The standard histamine test used by us for many years was employed. The dose of histamine was the same on successive tests and all examinations were made by the writer. The total secretions were collected over successive tenminute periods by continuous aspiration, and in the charts " volume " refers to the amount of such ten-minute yields. " Acidity" refers to the " total " acidity of successive specimens measured in the usual way. RESULTS

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The Normal Range of Gastric Acidity From Youth to Old Age

Cited by 146 publications

References 9 publications

Studies of Gastric Pepsin. I. Methods of Measurement and Factors Which Influence It

Studies of Gastric Pepsin. I. Methods of Measurement and Factors Which Influence It

A Study of the Gastric Secretion in Hyperthyroidism Before and After Operation

The Decrease of Gastric Secretion With Advancing Years: Further Observations

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