gastrins and Alkalosis

Topics: Adolescent; Adult; Age Factors; Aged; Alkalosis; Calcium; Female; Gastrectomy; Gastric Juice; Gastrins; Humans; Hyperparathyroidism, Secondary; Lymphatic Metastasis; Male; Middle Aged; Parathyroid Hormone; Recurrence; Vagotomy; Zollinger-Ellison Syndrome

To help determine the etiology and most appropriate treatment regimen for hypergastrinemia, dysuria-hematuria and metabolic alkalosis following augmentation gastrocystoplasty.. Two patients who presented with refractory metabolic alkalosis (1 with dysuria-hematuria) underwent extensive laboratory evaluation, complete upper gastrointestinal evaluation and intravesical pH probe placement.. Both patients eventually required high dose oral potassium chloride supplementation. Bladder mucosal pH was not reflected by buffered urinary pH. Both patients demonstrated significant gastroesophageal reflux and diminished overall gastric acid output.. Outpatient maintenance on potassium chloride supplementation may be warranted in select patients and appears to be preferable to histamine blockade or omeprazole. Postoperative screening esophagogastroscopy and an additional surgical maneuver might be indicated to prevent possible adverse sequelae of reflux esophagitis. Gastrocystoplasty may be an inappropriate operation in children with renal insufficiency who have not had metabolic acidosis.

Topics: Alkalosis; Child; Child, Preschool; Female; Gastric Mucosa; Gastrins; Hematuria; Humans; Male; Postoperative Complications; Stomach; Urinary Bladder

The use of segments of stomach for bladder augmentation is gaining popularity in pediatric urology due to favorable muscular and secretory properties. However, in a renal failure patient who underwent gastrocystoplasty a high level of acid production within the bladder associated with persistent hypergastrinemia was noted leading to severe systemic metabolic alkalosis. This condition was unresponsive to standard acid-inhibiting or neutralizing therapies but it was treated successfully with omeprazole, a proton-pump inhibitor recently introduced for treatment of peptic ulcer disease.

Topics: Alkalosis; Child, Preschool; Gastric Acid; Gastrins; Humans; Hydrogen-Ion Concentration; Male; Omeprazole; Postoperative Complications; Stomach; Urinary Bladder; Urine; Vesico-Ureteral Reflux

Topics: Alkalosis; Antacids; Calcium Carbonate; Carbonates; Drug Interactions; Gastric Juice; Gastrins; Humans; Hypercalcemia; Magnesium Oxide; Parasympatholytics; Pepsin A; Peptic Ulcer; Sodium; Stomach Diseases

In both normal volunteers and in patients with primary hyperparathyroidism, the induction of a metabolic alkalosis by infusion of sodium bicarbonate results in a decrease in serum calcium ion and in an increase of circulating parathyroid hormone concentrations. Bicarbonate infusion may serve in man as a new provocative test for release of parathyroid hormone. Furthermore, we speculate that the metabolic alkalosis which is found at times in patients with the Zollinger-Ellison syndrome and severe peptic ulcer disease may result in parathyroid gland stimulation.

Topics: Adult; Aged; Alkalosis; Bicarbonates; Calcium; Female; Gastric Juice; Gastrins; Humans; Hypercalcemia; Hyperparathyroidism; Male; Metabolic Clearance Rate; Middle Aged; Pancreatic Neoplasms; Parathyroid Hormone; Peptic Ulcer; Sodium Chloride; Zollinger-Ellison Syndrome

Topics: Acidosis; Alkalosis; Ammonium Chloride; Animals; Bicarbonates; Calcium; Female; Gastrins; Hydrochloric Acid; Hydrogen-Ion Concentration; Parathyroid Glands; Parathyroid Hormone; Pylorus; Sheep

Topics: Alkalosis; Antacids; Duodenal Ulcer; Gastric Juice; Gastrins; History, 18th Century; History, 19th Century; History, 20th Century; Humans; Pepsin A; Peptic Ulcer