gastrins and Cholelithiasis

In the high altitude environment the oxygen and air density are decreased, the temperature and humidity are low, there es an increase in radioactivity. These environmental factors influence on the human body; it has been known for many years that people born and living at high altitude have different morphological and physiological characteristic than those at low altitude. The digestive mechanism for adaptation or acclimation to high altitude has interested physiologist and clinicians for many years. The objective of this article is to present a brief overview of the digestive physiology and pathology in the high altitude.

Topics: Altitude; Bolivia; Cholelithiasis; Colonic Neoplasms; Diverticulum, Colon; Dyspepsia; Endopeptidases; Gallbladder Neoplasms; Gastric Mucosa; Gastrins; Gastrointestinal Diseases; Gastrointestinal Hemorrhage; Gastrointestinal Transit; Humans; Intestinal Obstruction; Intestines; Peptic Ulcer; Peru

Topics: Adenoma, Islet Cell; Chenodeoxycholic Acid; Cholecystokinin; Cholelithiasis; Dehydration; Diabetes Mellitus; Duodenal Ulcer; Gastric Inhibitory Polypeptide; Gastrins; Gastrointestinal Hormones; Humans; Motilin; Pancreatic Neoplasms; Secretin; Syndrome; Vasoactive Intestinal Peptide; Zollinger-Ellison Syndrome

Topics: Biliary Tract Diseases; Ceruletide; Cholangiography; Cholelithiasis; Duodenal Ulcer; Endoscopy; Gastrins; Gastrointestinal Diseases; Gastrointestinal Hemorrhage; Gastrointestinal Hormones; Humans; Intestinal Absorption; Lactose Intolerance; Pancreatic Diseases; Peptic Ulcer; Radionuclide Imaging; Secretin; Stomach Neoplasms

Topics: Animals; Bile; Cholangiography; Cholecystography; Cholelithiasis; Dogs; Duodenal Ulcer; Gallbladder; Gastrectomy; Gastric Juice; Gastrins; Humans; Secretin; Vagotomy; Vagus Nerve

To investigate the relationship between anatomic abnormalities and malfunction of Oddi sphincter with formation of bile duct pigment gallstone.. One hundred and twenty-three patients with a T tube after cholecystectomy and choledochotomy were divided into reflux group and control group by measuring the amounts of radioactivity of (99m)Tc-DTPA in the bile. Among them 53 were selected randomly to undergo choledochoscopic manometry. Basal pressure of Oddi's sphincter (SOBP), amplitude of Oddi's sphincter (SOCA), frequency of contraction (SOF), duration of contraction (SOD), duodenal pressure (DP), common bile duct pressure (CBDP) were scored and analyzed. The level of plasma motilin and serum gastrin of 45 patients and 12 healthy volunteers were measured by radioimmunoassay. The incidence rates of duodenal descending part diverticulum in patients with bile duct pigment stones, patients without alimentary tract diseases, patients with gallbladder polyps, patients with gallbladder stones were studied by means of barium meal examination. The incidence rates of intraduodenal peri-ampullary diverticulum in patients with primary bile duct pigment stones, patients with bile duct stone and gallbladder stones, patients with bile duct stones originating from the gallbladder, patients with inflammation and stricture of the extremity of bile duct and papilla, patients with cancer of the extremity of bile duct and papilla, patients with post-cholecystectomy syndrome were detected by duodenoscope.. Of the patients, 44 were detected with duodenal-biliary reflux (35.8%). SOBP, SOCA and CBDP in the reflux group were much lower than those in control group (P < 0.001). The level of serum gastrin and plasma motilin of the reflux group were much lower than those of control group (P < 0.01). Positive correlation was found between level of motilin and SOBP while level of gastrin was positively correlated with SOBP and CBDP. The incidence of duodenal diverticulum in patients with bile duct pigment stone was 36.62%, which was higher than that of the other 3 groups. The incidence rate of intraduodenal peri-ampullary diverticulum in patients with primary bile duct pigment stone was higher than that of patients with inflammation and stricture of the extremity of bile duct and papilla, patients with cancer of the extremity of bile duct and papilla and patients with bile duct stones originating from the gallbladder.. The patients with bile duct pigment stone have apparent duodenal-biliary reflux and infection of the bile duct. The state of structure and function of Oddi's sphincter is correlated significantly with bile duct pigment stone. The anatomic abnormalities and malfunction of Oddi's sphincter played an important role in the formation of bile duct pigment stone.

Topics: Adult; Aged; Aged, 80 and over; Bile Pigments; Cholelithiasis; Female; Gastrins; Humans; Male; Middle Aged; Motilin; Pressure; Radioimmunoassay; Retrospective Studies; Sphincter of Oddi

The effects of adaptation to two diets differing in the type of dietary fat on the gastric acid secretory response to food and on the circulating levels of gastrin, somatostatin and peptide YY (PYY) were examined in humans. The study involved 18 cholecystectomized subjects previously submitted to a 30-day adaptation period to diets containing olive (group O) or sunflower oil (group S) as the fat source. During the experiments, physiological stimulation was achieved by ingestion of 200 ml of oleic acid- (group O) or linoleic acid-enriched (group S) liquid mixed meals. These resulted in an immediate rise in gastric pH. In group S, the return to the premeal value was completed within 60 min, and a further decline to values significantly lower than the basal ones was observed at the end of the study period. In contrast, ingestion of the meal containing olive oil attenuated and prolonged the pH decrease after the meal, this being associated with the suppression of postprandial gastrin response. Food ingestion induced no significant changes in plasma somatostatin concentration in either group, and no significant differences were revealed between them during the basal or postprandial situations. Plasma PYY levels were consistently higher in group O throughout the entire study period, although significance was reached only at resting. In conclusion, our results show that a 30-day adaptation period to diets containing olive oil as the main source of dietary fat results, compared with those containing sunflower oil, in an attenuated gastric secretory function in response to a liquid meal in humans. The effects of olive oil were associated with a suppression of serum gastrin and higher levels of PYY.

Topics: Adult; Cholelithiasis; Dietary Fats, Unsaturated; Gastric Acid; Gastrins; Gastrointestinal Contents; Gastrointestinal Hormones; Helianthus; Humans; Middle Aged; Olive Oil; Peptide YY; Peptides; Plant Oils; Postoperative Care; Preoperative Care; Somatostatin; Sunflower Oil; Time Factors

The synchronous changes in antral gastrin and somatostatin release in anesthetized, nonatropinized duodenal ulcer patients and control subjects were investigated by serial intraoperative blood sampling from the right gastroepiploic vein. The mean basal antral plasma gastrin and somatostatin concentrations of the two groups did not differ significantly. The significantly greater gastric acid secretory response to systemic gastric acid stimulation (pentagastrin stimulation) in duodenal ulcer patients compared with that of control subjects was not linked to any difference in antral somatostatin release pattern. The decrease in antral plasma gastrin release was significantly lower after acid instillation and the increase was significantly higher after alkali instillation in duodenal ulcer patients compared with those of controls, indicating an abnormal gastrin response to intragastric pH changes in duodenal ulcer patients, which was again not found to be coupled to any significant difference in antral somatostatin release. The results suggest that an abnormal somatostatin-mediated inhibition of gastrin release and/or gastric acid secretion does not exist in duodenal ulcer patients.

Topics: Anesthesia; Atropine; Cholelithiasis; Duodenal Ulcer; Gastric Acid; Gastric Acidity Determination; Gastrins; Humans; Hydrogen-Ion Concentration; Pentagastrin; Pyloric Antrum; Somatostatin; Time Factors

Topics: Cholecystectomy; Cholelithiasis; Gastrins; Humans

In order to evaluate the effect of cholecystectomy on the gastric mucosa, the duodenogastric reflux of total and single bile acids, the number of parietal and gastrin cells, and the volume of gastric acid secretion were examined in 15 patients with gallstones and functioning gallbladders before and 6 months after cholecystectomy. The duodenogastric reflux of the total bile acids increased from a mean preoperative value of 1.9 mumol/hour to a mean postoperative value of 21 mumol/hour (p = 0.008). The duodenogastric reflux of all single bile acids increased after cholecystectomy, with a higher increase in glycoconjugated compared with tauroconjugated bile acids. The parietal cells decreased from a mean preoperative value of 82.8 to a mean postoperative value of 68.7 (p = 0.05), whereas there was only a mild increase in the number of gastrin cells; the output of gastric acid remained unchanged. The variation of the gastrin cells before and after cholecystectomy was negatively correlated only with the variation of taurocholic acid (r = -0.50, p = 0.05), while the variation of the parietal cells was mildly correlated with all single bile acids (r = 0.35-0.50, 0.05 less than p less than 0.02). These findings show an increased duodenogastric reflux of bile acids 6 months after cholecystectomy with a mild morphologic alteration of the gastric mucosa.

Topics: Adult; Aged; Bile Acids and Salts; Cholecystectomy; Cholelithiasis; Duodenogastric Reflux; Female; Gastric Acid; Gastrins; Humans; Male; Middle Aged; Parietal Cells, Gastric; Postoperative Period; Taurocholic Acid; Time Factors

The frequent occurrence of cholelithiasis noted in the follow-up of patients who underwent total gastrectomy because of Zollinger-Ellison syndrome prompted us to study this phenomenon. Cholelithiasis is known to be more common after truncal vagotomy, with or without concomitant subtotal gastric resection, and the prevalence of gallstones in these patients is reported to be 16% to 38%. To date, however, no long-term study has investigated the prevalence of gallstones after total gastrectomy in patients with the Zollinger-Ellison syndrome. Since 1961, 26 patients with the Zollinger-Ellison syndrome have undergone total gastrectomy and were enrolled in a Medical College of Wisconsin Clinical Research Center protocol that allowed follow-up to assess the development of cholelithiasis. Eight patients had cholecystectomy at the time of total gastrectomy (seven patients had stones), leaving 18 patients with a normal gallbladder and no gallstones at the time of total gastrectomy. Four patients died early, two of surgical complications, one of tumor progression, and one of alcohol-related trauma. During follow-up, cholelithiasis has developed in 10 of 14 patients (71%) at risk; the mean time to gallstones was 6.3 years (range, 1.2 to 12.9 years). The predictable occurrence of cholelithiasis after total gastrectomy in patients with the Zollinger-Ellison syndrome suggests that cholecystectomy should be performed at the time of total gastrectomy.

Topics: Adult; Aged; Child; Cholelithiasis; Female; Follow-Up Studies; Gastrectomy; Gastrins; Humans; Male; Middle Aged; Vagotomy; Zollinger-Ellison Syndrome

The concentrations of gastrin-releasing polypeptide, somatostatin (SS), and gastrin in extracts of endoscopically obtained biopsies from the fundus, antrum, and duodenum of patients with uncomplicated bile stones (controls) or duodenal ulcer disease were measured with specific radioimmunoassays. The validity of the tissue sampling was confirmed by characteristic and significant differences between gastrin concentrations at the different biopsy sites. Gastrin-releasing polypeptide levels were at their highest in the fundic and duodenal bulb compared to the antrum in controls (p less than 0.01), whereas no differences in gastrin-releasing polypeptide content of the different parts of the stomach were found in duodenal ulcer patients. Compared to controls gastrin-releasing polypeptide in duodenal ulcer patients was reduced in fundic and duodenal bulb mucosa (p less than 0.01). SS levels were highest (p less than 0.05) in the first part of duodenum in controls. Compared to controls duodenal ulcer patients had lower SS concentrations present in fundic (p less than 0.01) and highest SS concentrations present in duodenal bulb mucosa (p less than 0.01). There was no correlation between acid secretion and mucosal gastrin-releasing polypeptide or SS concentrations in any part of the stomach and duodenum.

Topics: Adult; Cholelithiasis; Duodenal Ulcer; Duodenum; Female; Gastric Acid; Gastric Fundus; Gastric Mucosa; Gastrin-Releasing Peptide; Gastrins; Humans; Intestinal Mucosa; Male; Middle Aged; Peptides; Pyloric Antrum; Somatostatin

Topics: Adult; Cholecystectomy; Cholelithiasis; Female; Gastric Acid; Gastrins; Humans; Male; Middle Aged; Postoperative Period; Vasoactive Intestinal Peptide

Topics: Bombesin; Cholelithiasis; Female; Gastrins; Humans; Male; Neuropeptides; Somatostatin; Substance P; Vasoactive Intestinal Peptide

Twelve patients with repeated episodes of jaundice and infection due to primary biliary duct stones were treated by interposing a 50-cm segment of the jejunum between the proximal common duct below the liver and the first portion of the duodenum. The interposed jejunum was positioned in a retrogastric position. There were no postoperative deaths, and laboratory data indicate no alteration in gastric secretion, gastrin levels, or barium reflux into the liver. After a mean follow-up period of 11.67 months, there was no need for further operations in these patients, all of whom had had previous multiple episodes of cholangitis and biliary colic.

Topics: Adult; Bilirubin; China; Cholangitis; Cholelithiasis; Common Bile Duct; Duodenum; Female; Follow-Up Studies; Gastric Acidity Determination; Gastric Juice; Gastrins; Humans; Jejunum; Male; Middle Aged; Radiography; Sodium

Topics: Blood Glucose; Cholelithiasis; Female; Gastrins; Humans; Insulin; Lipids; Male; Secretin

Topics: Adolescent; Adult; Aged; Chenodeoxycholic Acid; Cholelithiasis; Dietary Proteins; Fasting; Female; Gastrins; Humans; Male; Middle Aged; Radioimmunoassay; Stimulation, Chemical

Topics: Cholecystokinin; Cholelithiasis; Duodenal Ulcer; Esophageal Achalasia; Gastrins; Gastritis; Gastrointestinal Hormones; Humans; Pancreatic Diseases; Peptic Ulcer; Secretin; Stomach Neoplasms; Stomach Ulcer

Topics: Animals; Biliary Tract Diseases; Brain Diseases; Calcium; Cholecystectomy; Cholelithiasis; Cholesterol; Dihydroxyphenylalanine; Dogs; Duodenal Ulcer; Gastrectomy; Gastric Juice; Gastrins; Gastrointestinal Diseases; Humans; Hyperparathyroidism; Liver Diseases; Norepinephrine; Pancreas; Secretin; Serotonin; Stimulation, Chemical; Vagotomy

Topics: Cholelithiasis; Duodenal Ulcer; Fatty Liver; Gastric Acidity Determination; Gastrins; Gastrointestinal Diseases; Hepatitis; Humans; Lipid Metabolism; Liver Cirrhosis; Liver Diseases; Pancreas; Postgastrectomy Syndromes; Secretin; Sulfobromophthalein