gastrins and Esophageal-Achalasia

Topics: Adult; Biomechanical Phenomena; Esophageal Achalasia; Esophageal Diseases; Esophagitis, Peptic; Esophagogastric Junction; Esophagus; Female; Gastrins; Hernia, Hiatal; Humans; Male; Middle Aged; Muscle Tonus; Muscle, Smooth; Parasympatholytics; Pentagastrin

Topics: Digestion; Esophageal Achalasia; Esophagitis, Peptic; Gastric Inhibitory Polypeptide; Gastric Mucosa; Gastrins; Gastritis; Glucagon; Humans; Ileum; Islets of Langerhans; Jejunum; Kidney Failure, Chronic; Liver; Protein Hydrolysates; Pyloric Antrum; Somatostatin; Vagotomy; Vasoactive Intestinal Peptide; Zollinger-Ellison Syndrome

Topics: Anemia, Pernicious; Animals; Cholecystokinin; Esophageal Achalasia; Esophagogastric Junction; Esophagus; Estradiol; Gastric Juice; Gastrins; Glucagon; Humans; Hydrogen-Ion Concentration; In Vitro Techniques; Opossums; Pressure; Progesterone; Secretin; Zollinger-Ellison Syndrome

Topics: Atropine; Barium Sulfate; Deglutition; Esophageal Achalasia; Esophageal Diseases; Esophagus; Gastrins; Gastroesophageal Reflux; Humans; Manometry; Muscle Contraction; Nitroglycerin; Peristalsis; Pressure; Pyridostigmine Bromide; Radiography

Topics: Animals; Cats; Chronic Disease; Creatinine; Dogs; Duodenal Ulcer; Esophageal Achalasia; Esophageal Diseases; Gastric Mucosa; Gastrins; Gastritis; Humans; Hydrogen-Ion Concentration; Kidney Failure, Chronic; Peptic Ulcer; Pyloric Antrum; Rats; Scleroderma, Localized; Stomach Neoplasms; Vagotomy; Zollinger-Ellison Syndrome

Topics: Cineradiography; Deglutition Disorders; Esophageal Achalasia; Esophageal Diseases; Esophageal Stenosis; Esophagogastric Junction; Esophagoscopy; Gastrins; Gastroesophageal Reflux; Heartburn; Hernia, Diaphragmatic; Humans; Manometry

Topics: Animals; Child; Digestive System; Esophageal Achalasia; Esophagus; Female; Gastrins; Humans; Male; Motor Activity; Pressure; Radiography; Vagus Nerve

Topics: Animals; Cholecystokinin; Esophageal Achalasia; Esophagogastric Junction; Gastrins; Gastroesophageal Reflux; Gastrointestinal Motility; Hernia, Diaphragmatic; Humans; Pentagastrin; Pressure; Secretin

Topics: Cholecystokinin; Drug Hypersensitivity; Esophageal Achalasia; Esophagogastric Junction; Gastrins; Gastrointestinal Hormones; Humans; Secretin

Topics: Abdomen; Duodenal Diseases; Duodenal Neoplasms; Duodenal Ulcer; Esophageal Achalasia; Esophageal Diseases; Esophageal Neoplasms; Esophagitis; Esophagoplasty; Esophagus; Female; Gastrins; Gastrointestinal Hemorrhage; Hernia, Diaphragmatic; Humans; Male; Peptic Ulcer; Peptic Ulcer Perforation; Postoperative Complications; Rupture, Spontaneous; Stomach Diseases; Stomach Neoplasms; Stomach Ulcer; Stress, Psychological; Vagotomy

Topics: Adult; Aged; Cholecystokinin; Dose-Response Relationship, Drug; Esophageal Achalasia; Esophagogastric Junction; Gastrins; Humans; Middle Aged; Muscle Contraction; Parasympathetic Nervous System

The aim of this study was to determine the contribution of preoperative gastric secretory and hormonal response, to the appearance of Barrett's esophagus in the esophageal stump following subtotal esophagectomy.. Thirty-eight end-stage chagasic achalasia patients submitted to esophagectomy and cervical gastric pull-up were followed prospectively for a mean of 13.6 +/- 9.2 years. Gastric acid secretion, pepsinogen, and gastrin were measured preoperatively in 14 patients who have developed Barrett's esophagus (Group I), and the results were compared to 24 patients who did not develop Barrett's esophagus (Group II).. In the group (I), the mean basal and stimulated preoperative gastric acid secretion was significantly higher than in the group II (basal: 1.52 vs. 1.01, p = 0.04; stimulated: 20.83 vs. 12.60, p = 0.01). Basal and stimulated preoperative pepsinogen were also increased at the Group I compared to Group II (Basal = 139.3 vs. 101.7, p = 0.02; stimulated = 186.0 vs. 156.5, p = 0.07. There was no difference in preoperative gastrin between the two groups. Gastritis was present during endoscopy in 57.1% of the Group I, while it was detected in 16.6% of the Group II, p = 0.014.. Barrett's esophagus in the esophageal stump was associated to high preoperative levels of gastric acid secretion, serum pepsinogen, and also gastritis in the transposed stomach.

Topics: Adult; Barrett Esophagus; Chagas Disease; Epithelium; Esophageal Achalasia; Esophagectomy; Female; Gastric Acid; Gastrins; Humans; Male; Middle Aged; Pepsinogen A; Preoperative Period; Risk Assessment; Young Adult

1. Patients with chronic Chagas' disease have abnormally low gastric acid secretion and increased gastrin release both during fasting and after different stimuli. Regardless of the relationship between intragastric acidity and gastrin secretion, it is uncertain whether hypergastrinemia in Chagas' disease is caused by an increased population of antral gastrin (G) cells (hyperplasia) or by enhanced cell activity (hyperfunction). 2. We therefore estimated G cell number in antral biopsies from 16 chagasic patients and 13 control subjects using a peroxidase-anti-peroxidase immunohistochemical technique. All subjects underwent a gastric secretion test to determine peak acid output following intravenous pentagastrin instillation. 3. Antral G cell number in Chagas' disease patients was not significantly different from that observed in the control group (number of cells/mm2, median and (range): 128 (44-284) vs 138 (65-285)). 4. In chagasic patients, peak acid output was significantly lower than in controls (mmol/h, median and (range): 9.819 (3.024-21.564) vs 17.490 (9.423-25.848)). 5. These results suggest that the increase in gastrin release associated with reduced gastric acid secretion in Chagas' disease is mediated by antral G cell hyperfunction rather than by hyperplasia.

Topics: Adult; Cell Count; Chagas Disease; Chronic Disease; Esophageal Achalasia; Female; Gastric Acid; Gastric Mucosa; Gastrins; Humans; Male; Megacolon; Middle Aged; Pyloric Antrum

Topics: Adult; Aged; APUD Cells; Cell Count; Duodenum; Esophageal Achalasia; Female; Gastric Mucosa; Gastrins; Humans; Insulin; Intestinal Mucosa; Male; Middle Aged; Prolactin; Stomach; Thyrotropin

The effect of a bolus intravenous administration of secretin (2.0 U/kg) on resting lower esophageal sphincter pressure (LESP) was investigated in seven patients with esophageal achalasia. Basal LESP before secretin injection in the patients was 60.1 +/- 3.4 mmHg (Mean +/- SEM), which was significantly higher than 26.9 +/- 2.5 mmHg in normal controls consisting of eight healthy volunteers. LESP significantly decreased within 1 min after the injection both in the patients and the controls. The maximum pressure change from each basal LESP was 31.2 +/- 5.2 mmHg in the patients, which was significantly greater than 12.1 +/- 1.8 mmHg in the controls. The effect of secretin disappeared within 5 min in the controls. The effect in the patients, however, lasted throughout the investigation time of 30 min. It is concluded that secretin has a long-acting effect on muscular relaxation of the lower esophageal sphincter in esophageal achalsia patients.

Topics: Adult; Esophageal Achalasia; Esophagogastric Junction; Female; Gastrins; Humans; Male; Pressure; Secretin; Time Factors

Topics: Esophageal Achalasia; Gastrins; Humans; Recurrence

Experimental achalasia dogs produced with Deloyer's method showed higher resting pressure at the gastroesophageal junction and the increase in LES pressure in response to tetragastrin and cholecystokinin. Dose-response curve of the LES to each dose of tetragastrin in achalasia dog shifted to the left. Resting LES pressure in 11 patients with achalasia was 42.73 +/- 23.31 cm H2O. It increased significantly after intramuscular injection of 5 micrograms/kg of tetragastrin and fluoroscopic observation showed the tonic contraction of the lower esophagus and cardia. After the performance of Jekler-Lhotka operation, LES pressure decreased to lower values sufficient to prevent the gastroesophageal reflux. Comparing 5 kinds of hiatal herniorrhaphies in dogs, LES pressure increased postoperatively in the following order: Nissen, Belsey Mark IV, Stensrud, Hill and Harrington methods. Responses to tetragastrin increased after Nissen and Belsey Mark IV methods. In 12 out of 21 clinical cases of sliding esophageal hiatal hernia who had undergone Nissen-Rossetti method adding fundopexy and posterior gastropexy, preoperative esophageal manometry showed HPZ of 24.98 +/- 8.87 cm H2O in peak value and 5.1 +/- 3.46 cm in length. Seven cases showed the biphasic pattern and 5 cases showed the negative response to tetragastrin. Postoperative manometry showed HPZ of 31.42 +/- 18.46 cm H2O in peak value and 4.5 +/- 1.73 cm in length. One case showed the biphasic pattern and 3 cases showed the negative response to tetragastrin.

Topics: Animals; Dogs; Esophageal Achalasia; Gastrins; Gastrointestinal Hormones; Hernia, Diaphragmatic; Hernia, Hiatal; Humans

Serum gastrin and lower esophageal sphincter (LES) responses to somatostatin infusion were evaluated in ten normal subjects and in nine achalasic patients in order to determine evidence of hormonal (presumably gastrin)control of LES pressure. After somatostatin infusion, a significant decrease of serum gastrin was observed in normal subjects at 30 min (81.6 +/- 3.2 versus 40.0 +/- 4.7 pg/ml; p less than 0.01) and a rapid increase of LES pressure was also observed (26.0 +/- 1.3 versus 34.1 +/- 1.6 mmHg; p less than 0.01). In achalasia no change was observed in serum gastrin concentration after somatostatin infusion. LES pressure at 20 min however significantly decreased (45.8 +/- 7.6 versus 31.6 +/- 2.3 mmHg; p less than 0.05). Endogenous gastrin is not a major control factor for LES pressure in either normal or achalasic subjects.

Topics: Adult; Aged; Esophageal Achalasia; Esophagogastric Junction; Female; Gastrins; Humans; Male; Middle Aged; Pressure; Somatostatin

Topics: Adolescent; Adult; Aged; Esophageal Achalasia; Esophagogastric Junction; Female; Gastric Acid; Gastrins; Histamine; Humans; Male; Middle Aged

The present study was designed to investigate basic and clinical problems of intraluminal lower esophageal sphincter (LES) manometry. As for the basic study, manometry apparatuses, measuring conditions and methods were revalued. For clinical study, effects of gastric contents and gastrin were studied with special reference to the asymmetry of the LES. The results obtained may be summarized as follows: Occlusion test performed in a LES model and dogs showed that the rate of pressure increase was greater in proportion to the greater perfusion rate as well as to smaller calibre of the manometry tube. The lower esophageal sphincter pressure (LESP) became greatest when the perfusion rate was increased up to a certain level and also when the withdrawal speed of a manometry tube was slowed down to a certain speed. Analysis of LES from the point of respiratory reversal disclosed that the pressure was greatest at the direction of 8 o'clock followed by those at 0 and 4 o'clock. The length of LES was longest at 4 o'clock followed by those at 0 and 8 o'clock. These differences in length of LES was mostly in accordance with the length of LES caudal to the point of respiratory reversal. LESP measured in different postures was greatest in the prone position suggesting the effect of intraabdominal pressure. Intragastric instillation of saline resulted in increase of intragastric pressure and LESP. Asymmetry of the LES in patients with sliding hiatal hernia, esophageal varices and achalasia showed profiles specific to the individual lesion.

Topics: Adult; Aged; Animals; Dogs; Esophageal Achalasia; Esophageal and Gastric Varices; Esophagogastric Junction; Fasting; Gastrins; Hernia, Hiatal; Humans; Intubation, Gastrointestinal; Male; Manometry; Middle Aged; Perfusion; Posture; Respiration

Topics: Esophageal Achalasia; Female; Gastrins; Humans; Middle Aged

Topics: Adult; Aged; Esophageal Achalasia; Esophagogastric Junction; Female; Gastrins; Humans; Middle Aged; Pressure

Topics: Chronic Disease; Esophageal Achalasia; Esophagus; Gastrins; Humans; Manometry

Topics: Animal Feed; Animals; Cat Diseases; Cats; Dog Diseases; Dogs; Esophageal Achalasia; Esophagogastric Junction; Esophagus; Gastrins; Gastroesophageal Reflux; Prognosis; Secretin

In investigations with various groups of patients there was no correlation between fasting serum IRG levels and LES pressures in individual subjects with undisturbed for disturbed sphincters. After food ingestion a short phase of LES pressure increase (from 13.5 +/- 1.5 to 21.7 +/- 3.8 mm Hg) could be observed. This peak occurs during the phase of rise in gastrin level, but there was no correlation between IRG levels and LES pressure in individual cases. In patients with gastroesophageal reflux we can demonstrate a diminished release of gastrin after a test meal, but there was also a diminished capacity of the LES. In conclusion, in this investigation it has not been possible to show a clear connection in humans between serum IRG and LES function.

Topics: Esophageal Achalasia; Esophagogastric Junction; Gastrins; Gastroesophageal Reflux; Humans; Pressure; Time Factors; Zollinger-Ellison Syndrome

Topics: Adolescent; Adult; Aged; Animals; Dogs; Esophageal Achalasia; Female; Gastrins; Gastrointestinal Hormones; Humans; Male; Middle Aged

Studies were carried out in a case of achalasia. Administration of secretin caused relaxation of the spastic condition of LES, and high levels of serum gastrin and lower levels of plasma secretin are suggested to be related with the abnormally spastic condition of LES in the patient.

Topics: Adult; Esophageal Achalasia; Esophagus; Gastrins; Humans; Male; Methods; Muscle Contraction; Muscle Relaxation; Pressure; Secretin

Topics: Esophageal Achalasia; Esophagitis; Esophagogastric Junction; Gastrins; Gastroesophageal Reflux; Gastrointestinal Hormones; Humans

Topics: Cholecystokinin; Esophageal Achalasia; Gastrins; Humans; Secretin

The purpose of this study was to evaluate the effect of intravenous pentagastrin and gastric alkalinization on the lower esophageal sphincter (LES) pressure in seven patients with diffuse esophageal spasm as compared to nine normal controls. Intravenous injections of 0.2 and 0.4 mug pentagastrin/kg body weight increased LES pressure significantly more in patients than in control subjects (p less than 0.05, p less than 0.01). Following gastric alkalinization both groups showed increases in LES pressure, but these were significantly greater for patients with diffuse esophageal spasm (p less than 0.05) than for controls. The results of our study indicate that the LES in patients with diffuse esophageal spasm is supersensitive to pentagastrin and gastric alkalinization.

Topics: Esophageal Achalasia; Esophagogastric Junction; Esophagus; Gastric Juice; Gastrins; Humans; Middle Aged; Pentagastrin; Pressure; Stimulation, Chemical

Topics: Esophageal Achalasia; Esophagogastric Junction; Esophagus; Gastrins; Humans; Manometry; Myenteric Plexus

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

Topics: Animals; Calcitonin; Ceruletide; Cholecystokinin; Dogs; Dose-Response Relationship, Drug; Esophageal Achalasia; Esophagogastric Junction; Gastrins; Gastrointestinal Hormones; Glucagon; Humans; Manometry; Muscle Tonus; Secretin

Topics: Animals; Esophageal Achalasia; Esophagus; Gastric Juice; Gastrins; Gastroesophageal Reflux; Humans; Muscle, Smooth; Opossums; Pressure

Topics: Esophageal Achalasia; Esophageal Diseases; Esophagogastric Junction; Esophagus; Gastrins; Gastroesophageal Reflux; Humans; Muscle, Smooth

Intraluminal manometric studies were carried out in 19 patients with untreated achalasia and in 20 normals. Lower esophageal sphincter (LES) pressure was 50.5 +/-4.6 mm Hg in patients with achalasia as compared with 19.4 +/-1.3 mm Hg in the normal group. In both groups, the LES pressure was lowered when exogenous 0.1 N HCl was placed into the stomach. Although the nadir of pressure attained with acid suppression was the same, the per cent inhibition was significantly greater in patients with achalasia. Serum gastrin levels were the same in the two groups studied. The patients with achalasia, pre- and postpneumatic dilatation, showed a supersensitivity to exogenous intravenous gastrin I, as compared with normals. These data suggest that high, acid-suppressible levels of LES pressure, in patients with achalasia, are due to supersensitivity to endogenous gastrin.

Topics: Adolescent; Adult; Aged; Child; Esophageal Achalasia; Esophageal Diseases; Esophagus; Gastrins; Humans; Manometry; Methacholine Compounds; Middle Aged; Pressure

Topics: Aged; Esophageal Achalasia; Gastrins; Humans; Male; Stomach Ulcer; Vagus Nerve