Gastric juice volume

Gastric juice volume and acid output are increased in obese individuals. 

In the presence of an accurate nasogastric tube placement, most studies using nonabsorbable volume markers have reported about a 90% recovery, indicating that an inevitable loss of about 10% of the gastric juice volume occurs through the pylorus. The infusion of nonabsorbable volume markers is used to improve the accuracy of the recovered gastric volumes. Table 1 summarizes marker substances that have been used and those that have potential for human use and their methods of estimation. Of these markers, poly(ethylene glycol) (PEG) has been the most widely used. However, the methods used for its estimation are still laborious, nonspecific, insensitive, and are associated with analytical errors. In addition. 

Gana TJ, MacPherson BR, Ng D, and Koo J (1990) Cobalt as a gastric juice volume marker Comparison of two methods of estimation. Journal of Surgical Research 48 78-83. 

Mechanism of Action An Hj-blocker that inhibits histamine action at histaminej receptors of gastric parietal cells. Therapeutic Effect Inhibits gastric acid secretion when fasting, at night, or when stimulated by food, caffeine, or insulin. Reduces volume and hydrogen ion concentration of gastric juice. 

The primary pharmacologic action of omeprazole is the reduction of Volume of gastric juice... 

It has use in prophylaxis of acid aspiration syndrome after induction of anaesthesia. In a dose of 150 mg HS as premedication affords reliable protection against the consequences of acid aspiration until 11 AM the next day and decreases the danger of aspiration by reducing the high volumes of gastric juice. 

It is a steroid like triterpenoid synthetic derivative of glycyrrhizic acid (obtained from liquorice) and has been found to be effective in healing both gastric and duodenal ulcer without affecting volume or acidity of gastric juice. 

In clinical work many biological fluids have been submitted to paper electrophoretic separation. Serum and urine have been studied extensively and the results were reviewed in Volume I of this series (p. 238). Other fluids include cerebrospinal fluid (B12, B14, E6, K18), pleura] fluid (D4), gastric juice (H6), ascitic fluid (H9), synovial fluid (W3), proteins of the lens (F4, W9, W10), aqueous humor of the eye (W12, W24), edema liquid (W23), and pericardiac effusion (G2). Apart from the general separation of plasma proteins, work has been done on special protein groups, such as lipo- and glycoproteins, muco-proteins, hemoglobins (H19), coagulation factors (05), and on other components, such as amino acids. 

The volume of the collected gastric juice is measured. Acid concentration is measured by titration against 100 mm NaOH to an endpoint of pH 7. Total acid output (mmol H+/3 h) is calculated and percent inhibition of the treated rat group is calculated against the control group. Using various doses, dose-response curves can... 

Q4 List the components of gastric secretion and the approximate volume of gastric juice secreted per day. 

The recent fractionation work of Seijffers et al. (S17-S19b) on DEAE-cellulose and that of Grabar and Burtin s laboratory by Rapp et al. (Rl), Kushner et al. (K32), and Hirsch-Marie et al. (H20b) utilizing agar gel electrophoresis and immunoelectrophoresis, resulted in differentiation of 3 to 4 proteases in human gastric juice, each having its own proenzyme. Detailed discussion of this work is presented in the companion review (G21) of the author, in this volume. 

When 1.5 volumes acetone is added to the trichloroacetic acid filtrate of the gastric juice, an abundant flocculent precipitate forms, which contains all the components of dissolved mucin with the exception of soluble mucus. If this precipitate is taken up in dilute alkali and then acidified with dilute HCl down to pH 3.5, a fine flocculent precipitate forms, which we named dissolved mucoprotein (G27, G36). It was later renamed glandular mucoprotein (G9, G38) because of its close relationship to the fundic glands of the stomach. This material contained much protein its nitrogen content was 12.61 0.44% and its tyrosine content 7.50 0.65% by the Folin-Giocalteu reaction. The reducing substance content was 6.38 1.48% before and 12.5% after hydrolysis (G9, G27, G36) (see Table 4). Werner (W9) determined the composition of this mucoprotein fraction and found that it contained 11.2% N by Kjeldahl, 8.8% hexosamine, 4.8% uronic acid, and 2.0% sialic acid. 

Another method is the iodometric procedure described by the reviewer (G6, G7), where dissolved mucin was precipitated with 1.5 volumes of acetone at 40°G from trichloroacetic acid filtrate of the gastric juice. Mucin, in the precipitate, was quantitated by iodometric titration with the use of a standardization curve of electrodialyzed mucin solution and methylene blue as indicator. The mucin values of gastric juice determined by this method were 20-210 mg%, those of saliva 50-300 mg %. The method was subsequently used by many investigators, yielding satisfactory results (K6, K20, M25, M52, T33, W20, W21) it was considered to yield accurate results (Przylecki, cited in K20) with 6% error (Labby et al, cited in T33). 

The most valuable and convincing information on the passage of serum proteins into the gastric juice was yielded by paper electrophoresis (G16, G42, G76, H15, H19) and immunological techniques (F3, H20-H20b, H34, H41, H55, S22). The results of this extensive work of many investigators are reported in the second review of the author in this volume (pp. 389 and 419). 

Another antibody was experimentally produced in rabbits by injecting pepsin (G5). It was detected by the Ouchterlony technique and precipitation reactions, and may have some clinical significance in producing atrophy of chief cells. Repeated injection of this immune serum into rats also caused decrease in the volume of gastric juice, with lower concentrations of acid and pepsin. The controls injected with antibodies to egg albumin, nonspecific globulins, and saline did not show similar changes (see Fig. ). 

This material, described by Nakahara and Fukuoka (Nl), is present only in cancer gastric juice. Upon intraperitoneal injection into mice, it depresses the catalase titer of the liver, kidney, and blood. The relationship of this material to mucopolysaccharides and mucoproteins of gastric juice is not well known. Toxohormone— like material obtained from normal stomach which is biologically inactive, however—was found to have lower polarographic activity than that from stomachs with gastric cancer (M18). Separation of materials with toxohormone activity by continuous electrophoresis on paper curtain and column chromatography is discussed in the following review in this volume. 

Kakei and Kubo (G13, G14) in our laboratory further demonstrated that vitamin Bi2 binders from the gastric juice were eluted into the excluded volume of Sephadex G-lOO and G-200 eolumns. Bound radioactive Bi2 was excluded from the gels and formed one large symmetrical peak, appearing between the first and second peaks of proteins (Fig. 39). 

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