gastrins and Postgastrectomy-Syndromes

Topics: Adult; Antineoplastic Agents; Cimetidine; Diagnosis, Differential; Gastrectomy; Gastric Acid; Gastric Mucosa; Gastrins; Humans; Middle Aged; Postgastrectomy Syndromes; Pyloric Antrum; Secretin; Vagotomy; Zollinger-Ellison Syndrome

Topics: Acute Kidney Injury; Adenoma, Islet Cell; Apudoma; Dehydration; Gastrins; Gastrointestinal Hormones; Gastrointestinal Neoplasms; Humans; Multiple Endocrine Neoplasia; Pancreatic Neoplasms; Paraneoplastic Endocrine Syndromes; Parathyroid Neoplasms; Pheochromocytoma; Postgastrectomy Syndromes; Somatostatin; Syndrome; Thyroid Neoplasms; Zollinger-Ellison Syndrome

Topics: Duodenal Ulcer; Female; Gastric Acidity Determination; Gastric Juice; Gastrins; Gastrointestinal Motility; Glucose; Histamine; History, 20th Century; Humans; Insulin; Male; Methylene Blue; Nerve Regeneration; Pentagastrin; Pepsin A; Peptic Ulcer; Postgastrectomy Syndromes; Preoperative Care; Pyloric Antrum; Radioimmunoassay; Recurrence; Sex Factors; Stomach; Sympathectomy; Time Factors; Vagotomy

Topics: Duodenal Ulcer; Gastrectomy; Gastric Mucosa; Gastrins; Humans; Pepsin A; Peptic Ulcer; Postgastrectomy Syndromes; Postoperative Complications; Stomach Ulcer; Vagotomy; Vagus Nerve

Topics: Adolescent; Adult; Aged; Anemia, Hypochromic; Anemia, Pernicious; Atrophy; Autoantibodies; Autoimmune Diseases; Chronic Disease; Female; Gastrins; Gastritis; Gastrointestinal Hemorrhage; Humans; Male; Middle Aged; Postgastrectomy Syndromes; Stomach Neoplasms; Stomach Ulcer

Topics: Afferent Loop Syndrome; Deglutition Disorders; Diet Therapy; Dumping Syndrome; Gastric Acidity Determination; Gastrins; Gastroenterostomy; Gastroscopy; Humans; Hyperparathyroidism; Malabsorption Syndromes; Pentagastrin; Peptic Ulcer; Postgastrectomy Syndromes; Postoperative Complications; Stomach; Stomach Ulcer; Sutures; Zollinger-Ellison Syndrome

Topics: Celiac Disease; Cholecystokinin; Digestion; Gastrins; Gastrointestinal Hormones; Homeostasis; Humans; Postgastrectomy Syndromes; Secretin; Vagotomy; Zollinger-Ellison Syndrome

Topics: Animals; Arginine; Blood Glucose; Cholecystokinin; Cyclic AMP; Diabetes Mellitus; Dietary Proteins; Digestive System Physiological Phenomena; Gastrins; Glucagon; Humans; Hypoglycemia; Insulin; Insulin Secretion; Islets of Langerhans; Portal System; Postgastrectomy Syndromes; Regional Blood Flow; Secretin; Serotonin

A comparison was done between the F. Paulino jejunal pouch (FP) and a jejunal pouch (JP) as esophagus-duodenum interpositional graft, for replacing the stomach after total gastrectomy. It was investigated the effect of the two procedures on esophagus histology, nutritional state and serum gastrin in rats.. Male Wistar rats weighing 282 +/- 17g were randomly submitted to sham operation (S), FP and JP after total gastrectomy. After eight weeks the rats were killed with overdose of anesthetic and tissue was taken from the distal esophagus for histology. Serum levels of total proteins, albumin, iron, transferring, folate, cobalamine, calcium, as well as serum gastrin were determined. Survival was considered.. Fourty six rats were operated and thirty survived for eight weeks. Five (33.3%) died after FP and 11 (52.3%) after JP (p < 0.05). Postoperative esophagitis occurred in 6 JP rats. At 8th week, no difference was observed on body weight when compared FP and JP rats (p > 0.05). The JP rats had a significant decrease in serum albumin, glucose, transferrin, iron, folate and calcium, compared to sham (p < 0.05). Serum gastrin, iron and calcium were significantly higher in JP rats than in FP rats (p < 0.05). In FP rats, transferrin and cobalamine showed significant decrease comparing the preoperative with 8th week levels (p < 0.05).. F. Paulino pouch in rats had lower mortality than JP, and esophagitis was not detected in it. JP rats had serum gastrin, iron and calcium unaffected, possibly because of preservation of duodenal passage.

Topics: Analysis of Variance; Anastomosis, Roux-en-Y; Animals; Blood Glucose; Duodenum; Esophagitis, Peptic; Esophagus; Gastrectomy; Gastrins; Jejunum; Male; Nutritional Status; Postgastrectomy Syndromes; Rats; Rats, Wistar; Serum Albumin; Vitamin B 12

The postoperative results of pylorus-preserving gastrectomy (PPG) for gastric ulcer performed in 134 patients during the past 25 years (mean postoperative period, 16.6 years) were studied. The incidence of postoperative complications was low. Dumping syndrome occurred in only 4.4% and 0% of cases as assessed by questionnaire and interview, respectively. Four (5.4%) of 74 patients available for this study had ulcer recurrence. In one of these four patients concurrent gastroduodenal ulcer was suspected from preoperative gastric analysis. The site of recurrence was found in all cases to be the remnant antral gland area along the greater curvature between the proper gastric gland area and the duodenum. Basal and maximal acid outputs at the time of relapse were significantly higher in patients with recurrence than in patients without recurrence. The fasting and postprandial serum gastrin levels were high in one patient with recurrence, whose antrum was preserved as long as 3 cm proximal to the pyloric ring; this was longer than that described in our original method of PPG. In two other recurrent cases the serum gastrin levels were not different from those in nonrecurrent cases. Immunohistochemical examination of the residual antrum showed no increase in the G-cell density in patients either with or without recurrence. These results suggest that the long-term quality of life of patients treated with PPG remains favorable. Recurrence rate can be further reduced if PPG is strictly indicated for gastric ulcer only and carried out by meticulous surgical techniques. In the pathogenesis of the ulcer recurrence the role of gastrin release from the residual antral mucosa seems to be limited.

Topics: Adult; Female; Follow-Up Studies; Gastrectomy; Gastric Acid; Gastric Acidity Determination; Gastric Mucosa; Gastrins; Humans; Male; Middle Aged; Postgastrectomy Syndromes; Postoperative Period; Pylorus; Radiography; Recurrence; Stomach Ulcer

In a follow-up study operative risk, postoperative functional disorders and incidence of anastomotic (recurrent) ulcer after partial gastrectomy with Roux-en-Y gastrojejunostomy for gastroduodenal ulcer were evaluated in 52 patients. Lethality for elective treatment was 0 and for emergency surgery (ulcer bleeding) 16.7%. 29.5% of the patients reported postoperative functional disorders. Because Roux-en-Y reconstruction prevented duodenogastric reflux, intragastric pH was low (median 2.2) and in the absence of ulcer protective, neutralizing reflux anastomotic ulcer occurred in 15.9% of the patients. With regard to the high rate of recurrent ulcer Roux-en-Y reconstruction after partial gastrectomy for primary ulcer surgery should be avoided and reconstruction procedures preferred, which guarantee duodenogastric reflux.

Topics: Anastomosis, Roux-en-Y; Bile Reflux; Female; Follow-Up Studies; Gastrectomy; Gastric Acidity Determination; Gastrins; Humans; Jejunum; Male; Peptic Ulcer; Postgastrectomy Syndromes; Postoperative Complications; Radiography; Recurrence

The ulcer risk of the Roux-Y anastomosis following gastric resection was analyzed experimentally in 82 rats. After 1/3 gastric resection a Roux-Y gastrojejunostomy with jejunal loops of 3, 6, 9 and 15 cm was performed. 10 months postoperatively a follow-up was performed consisting of endoscopy, measurement of pH-values, analysis of gastric secretion and serum gastrin, gastric emptying tests and histamine stimulation. Endoscopically there was a high rate of stomal ulceration related to the length of the jejunal loop. In long Roux-Y loops (9 and 15 cm), that means under reflux-free conditions, ulcer incidence ranged from 72% to 92%. In short loops with reflux-exposed stomachs the frequency of ulceration was only 9%. With additional histamine stimulation there were stomal ulcers in 100% of the reflux-free animals, but only in 60% of the rats with short Roux-Y loops. In spite of resection acidity was high (pH 1.8) in reflux-free stomachs. Only the volume of gastric secretion and the amount of acid-output was reduced. Gastric acid secretion unbuffered by duodenal content is discussed as the major factor in the etiology of stomal ulcer in reflux-free stomachs. So the Roux-Y anastomosis following gastric resection is a modification of the Mann-Williamson experiment. Therefore reflux-free operations are heavily ulcer prone.

Topics: Animals; Gastrectomy; Gastric Acidity Determination; Gastric Emptying; Gastric Mucosa; Gastrins; Intestinal Mucosa; Jejunum; Male; Postgastrectomy Syndromes; Rats; Rats, Inbred Strains; Risk; Stomach Ulcer; Vagotomy, Proximal Gastric

Topics: Adult; Aged; Female; Gastrins; Humans; Male; Middle Aged; Peptic Ulcer; Postgastrectomy Syndromes; Zollinger-Ellison Syndrome

Topics: Adult; Female; Gastrectomy; Gastric Acidity Determination; Gastrins; Gastroenterostomy; Humans; Male; Middle Aged; Peptic Ulcer; Postgastrectomy Syndromes; Reoperation; Vagotomy

Topics: Dumping Syndrome; Gastric Acid; Gastrins; Gastroenterostomy; Humans; Peptic Ulcer; Postgastrectomy Syndromes

Topics: Adult; Gastrectomy; Gastrins; Humans; Male; Postgastrectomy Syndromes; Pyloric Antrum; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Technetium

Topics: Adult; Chronic Disease; Duodenal Ulcer; Gastrins; Humans; Middle Aged; Peptic Ulcer; Postgastrectomy Syndromes; Postoperative Period

The hypothesis that reflux of upper intestinal content, particularly of bile acids (BA), is responsible for a unique postgastrectomy syndrome, alkaline reflux gastritis, was tested on 28 occasions in 21 postoperative patients (14 symptomatic patients, 7 controls). Parameters evaluated: recumbent (rec.), upright, p.c. intragastric pH, {BA}, net BA reflux per hour, specific BA fractions, fasting and p.c. gastrin, maximal acid output (MAO), gastric emptying of solids by delta-scintigraphy), and the severity of nonstomal histologic gastritis, the "gastritis score," graded 0-15 by an independent senior pathologist. For the entire group, gastritis severity correlated positively with intragastric {BA} and net BA reflux per hour, both in recumbency and p.c. Five symptomatic patients demonstrated rec. and p.c. {BA} and net BA reflux per hour greater than two standard deviations from comparable mean values in control patients. They differed significantly from the remaining symptomatic patients as follows: increased intragastric {BA} and net BA reflux per hour, increased intragastric pH and decreased MAO. They also demonstrated a more severe grade of gastritis. Lithocholic acid was present in their reflux content significantly more often. Bilious vomiting was also more frequent. No other differences could be identified, either objectively or clinically, between the symptomatic groups. Four patients with excessive reflux underwent Roux-en-Y revision and restudy 6-22 months later. BA reflux was completely abolished, histologic gastritis improved, hematocrit rose, MAO increased, and gastric emptying slowed. Burning pain, bilious vomiting, and symptoms of esophageal reflux were eliminated. Vomiting and nausea were improved. Diarrhea was unchanged. The objective criteria outlined can identify symptomatic postgastrectomy patients with a greater than normal reflux and gastritis. Clinical criteria alone cannot. Revisional surgery in these patients eliminates reflux, improves gastritis, and produces symptomatic improvement. The hypothesis under consideration is strengthened but not proven.

Topics: Adult; Bile Acids and Salts; Female; Gastric Acid; Gastric Emptying; Gastric Mucosa; Gastrins; Gastritis; Humans; Male; Middle Aged; Postgastrectomy Syndromes

Topics: Dumping Syndrome; Gastric Acid; Gastric Mucosa; Gastrins; Humans; Peptic Ulcer; Postgastrectomy Syndromes; Pyloric Stenosis; Stomach Neoplasms

Topics: Adult; Aged; Duodenum; Female; Gastrins; Humans; Intestinal Mucosa; Jejunum; Male; Middle Aged; Postgastrectomy Syndromes; Pyloric Antrum

131 patients operated on for gastric ulcer according to Gillroth II were investigated with gastroscopy and biopsy. The histology of the gastric mucosa was correlated with the time elapsed since resection. In most cases gastritis shows no difference between anastomosis and stump. In up to 12% gastritis in the stump was more pronounced that at the anastomosis. In the stump any form of gastritis can be seen even more than 20 years afer resection. Atrophic changes are more often to be found in the resected stomach and develop more rapidly than in the normal stomach. They probably result from the coincidence of the lost protective function of the mucous membrane after resection of the gastrin-producing antrum with the potentially damaging action of the contents of small intestine.

Topics: Gastric Juice; Gastric Mucosa; Gastrins; Gastritis; Humans; Postgastrectomy Syndromes; Stomach Ulcer; Time

Topics: Duodenitis; Esophagitis, Peptic; Female; Gastrins; Gastritis; Humans; Male; Peptic Ulcer; Postgastrectomy Syndromes; Stomach Diseases; Stomach Neoplasms

Retained-antrum syndrome is a rare condition, occurring in Billroth II gastrectomised patients, in which an ulcer recurs associated with high levels of circulating gastrin. Some gastrin tests are useful to differentiate a retained antrum from a gastrinoma, but a firm diagnosis is sometimes very difficult. We have studied two cases of retained-antrum syndrome both by gastrin tests and by [99mTc] pertechnetate scintiphotography. By this method a prominent area of activity was observed on the anatomic site of the duodenal stump bottom. It appeared after 20 or 30 min and lasted for the 2 hr of observation. After surgical resection, no area of activity was observed at the scintiphotographic followup. No false positive was observed out of the more than 30 subjects studied. Scintiphotography by pertechnetate seems able to demonstrate the presence and the size of retained gastric antrum in B II gastrectomised patients with recurrent ulcer.

Topics: Diagnosis, Differential; Gastrins; Humans; Male; Middle Aged; Postgastrectomy Syndromes; Pyloric Antrum; Radionuclide Imaging; Technetium; Zollinger-Ellison Syndrome

Topics: Adult; Atropine; Duodenal Ulcer; Female; Gastrectomy; Gastrins; Humans; Male; Middle Aged; Parasympathetic Nervous System; Postgastrectomy Syndromes; Vagotomy

Topics: Calcium; Gastrectomy; Gastrins; Humans; Methods; Postgastrectomy Syndromes; Postoperative Complications; Preoperative Care; Recurrence; Secretin; Stomach Ulcer; Vagotomy

Extensive metabolic studies were conducted in five normal controls and in five study patients after total gastric resection with Roux-en-Y (RY) reconstruction to determine the nutritional consequences of this particular technique of restoring gastrointestinal continuity. Although malabsorption of fat (19.2 +/- 2.2%) and nitrogen (22 +/- 2.5%) demonstrated in the study patients was moderate, it was significantly greater than normal ( less than 0.01). In spite of the demonstrated malabsorption, however, positive nitrogen balances (+ 0.33 +/- 0.18 gm/day) were maintained in the RY patients throughout the investigative period. These observations suggest that malabsorption after RY is infrequently of clinical significance, even in this "worst-case" situation characterized by complete removal of gastric tissue. Malnutrition should occur in only those patients with more limited gastric resections and RY reconstruction who are unable to increase caloric intake to cover losses due to malabsorption. A significant decrease in both trypsin and lipase concentrations and a marked delay in secretion of these enzymes was noted in the RY patients in response to a test meal (p less than 0.01). Malabsorption of fat and nitrogen in RY patients improved after exogenous pancreatic enzymes, but not after administration of tetracycline. Bacterial overgrowth as a cause of postoperative malabsorption may be less important than previously thought. Malabsorption after RY is due primarily to maldigestion brought about by duodenal bypass which, in turn, results in either an absolute or a relative pancreatic enzyme insufficiency.

Topics: Bile Acids and Salts; Cholecystokinin; Dietary Fats; Female; Gastrectomy; Gastrins; Humans; Jejunum; Lipase; Malabsorption Syndromes; Male; Nitrogen; Postgastrectomy Syndromes; Secretin; Tetracycline; Trypsin

Over a period of 21 years 39 patients with gastrinoma were surgically treated. Thirty-three patients had total gastrectomy with two postoperative deaths, and 6 patients had a lesser procedure. The postoperative fasting gastrin levels remained elevated and did not always indicate the extent of tumor involvement. Further mobilization of tumor gastrin by provocative infusion of calcium gluceptate, 15 mg/kg of body weight, should be carried out routinely. A hepatic angiogram should be considered when the gastrin levels exceed 1,000 picograms per ml. Chemotherapy consisting of Tubercidin, Streptozotocin and 5-Fluorouracil was given to 5 patients with extensive gastrinoma. All patients felt better and gained from three to 35 pounds in weight. Since 60% of the patients died or have definite evidence of tumor activity it is assumed that the tumor growth was not inhibited and that it is malignant. Approximately 40% of the patients seem to do well despite modest elevations in gastrin levels suggesting that the retained tumor could be considered benign.

Topics: Adenoma, Islet Cell; Fasting; Fluorouracil; Gastrins; Humans; Liver Neoplasms; Neoplasm Metastasis; Neoplasm Recurrence, Local; Postgastrectomy Syndromes; Prognosis; Stomach Neoplasms; Streptozocin; Tubercidin

Selective proximal vagotomy with pyloroplasty is a method which permits ulcers to be operated on with less morphological and pathophysiological disturbances than is possible with any other method. After ingestion, a reactive yet reduced acid secretion is still possible through the gastrin stimulus. The retained vagal antral release of gastrin seems to be without importance to the denervated delomorphous cells. Side effects of this type of vagotomy are small. The disturbances of motility and evacuation which also occur here can easily be corrected by an additional pyloroplasty suitable in shape and function.

Topics: Animals; Bile; Dogs; Duodenal Ulcer; Gastric Juice; Gastrins; Gastrointestinal Motility; Glucose Tolerance Test; Humans; Insulin; Pancreatic Juice; Postgastrectomy Syndromes; Prognosis; Prospective Studies; Pylorus; Recurrence; Stomach Ulcer; Vagotomy

The development of the radioimmunoassay for gastrin has resulted in significant increases in our knowledge of the physiology of the stomach and antrum, and in an objective recognition of the interaction of the gastrin and vagus mechanisms. Recent identification of multiple species of gastrin in the circulation, however, raises questions as to the significance of early experimental results. Until the various aspects of gastrin and their relative contributions in the normal state and in pathologic processes are identified, the significance of gastrin levels in the evaluation of patients with uncomplicated ulcer disease is unclear. Although many investigators have attempted to correlate changes in serum gastrin levels in response to various stimuli with the completeness of vagotomy or the likelihood of recurrence, it is too early to give any clinical significance to these reports. Several points in particular seem worthy of emphasis: 1. Preoperative serum gastrin levels are currently of no value in selecting an operation for the treatment of duodenal ulcer disease. 2. The difference in serum gastrin levels in response to feeding that may be shown to exist between groups of normal subjects and duodenal ulcer patients is not a value in diagnosing ulcer disease in a specific patient, nor in differentiating duodenal ulcer from other conditions. 3. The measurement of serum gastrin levels in association with Hollander tests, while perhaps of potential future benefit, does not improve the accuracy of the Hollander test nor do results necessarily relate to vagal innervation. 4. Postoperative serum gastrin levels are increased after vagotomy. The degree of hypergastrinemia after vagotomy does not correlate with risk of ulcer recurrence. 5. Hypergastrinemia (greater than 1000 pg. per ml.) in the presence of hyperacidity is essentially pathognomonic of the Zollinger-Ellison syndrome. Calcium and secretin infusions do not add to the diagnosis if clear-cut clinical and laboratory data are present. These differential tests are of value in identifying the Zollinger-Ellison patient who has borderline serum gastrin levels and in differentiation from the syndrome of the retained antrum. 6. In a patient with a recurrent ulcer following surgery in whom a drug-induced ulcer can be excluded and gastric outlet obstruction cannot be demonstrated, a serum gastrin level may be indicated. A serum gastrin value greater than 300 pg. per ml. (normal less than 200 pg. per ml.) in a fastin

Topics: Animals; Calcium; Cats; Digestive System Physiological Phenomena; Dogs; Duodenal Ulcer; Gastrectomy; Gastrins; Humans; Postgastrectomy Syndromes; Radioimmunoassay; Secretin; Vagotomy; Vagus Nerve

A pathophysiological role of gastrin has been established only in the Zollinger-Ellison-Syndrome. Hypergastrinemia may be found in cases with prenicious anemia, atrophic gastritis and after all forms of vagotomy; furthermore in the excluded antrum syndrome, the short bowel syndrome, in renal insufficiency, pyloric stenoses and after oral or parenteral administration of calcium. The role of gastrin in the pathogenesis of duodenal ulcer is unknown.

Topics: Anemia, Pernicious; Duodenal Ulcer; Gastrins; Gastritis; Humans; Postgastrectomy Syndromes; Zollinger-Ellison Syndrome

Based on the data obtained in fibrogastrochromoscopy and histological studies of gastric biopsy specimens from patients with ulcerous gastroduodenal disease, prior to surgical intervention and after gastric resection for this affection, it was found that in "standard" gastric resection with 2/3 of the organ the possibility of remaining a portion of the antral mucous membrane in the gastric stump is practically excluded and, consequently, the role of this factor in the development of peptic ulcer of the anastomosis seems to unliely after the so-called inadquate in extent gastric resections.

Topics: Endocrine Glands; Evaluation Studies as Topic; Female; Gastrectomy; Gastrins; Humans; Male; Peptic Ulcer; Postgastrectomy Syndromes; Pyloric Antrum; Recurrence; Stomach

A retrospective study was made of 34 cases of recurrent ulcer following gastric resection. Males, especially above the age of 40, were shown to be particularly susceptible. The intact vagus apparently plays the most important role in the pathogenesis. Radiological examination and endoscopy are of the greatest diagnostic importance. Truncal vagotomy must be regarded as the treatment of choice in uncomplicated recurrent ulcer. Resection procedures are indicated in perforating ulcer, gastrojejunocolic fistula, antral remains and Zollinger-Ellison syndrome.

Topics: Adult; Duodenal Ulcer; Female; Gastrins; Germany, West; Humans; Male; Middle Aged; Peptic Ulcer; Postgastrectomy Syndromes; Recurrence; Retrospective Studies; Sex Factors; Stomach; Stomach Ulcer; Vagotomy; Zollinger-Ellison Syndrome

One hundred and twelve consecutive patients selected for surgical treatment for duodenal ulcer disease were treated by a graded gastrectomy according to the Moynihan modification of the Billroth II partial gastrectomy. A large partial gastrectomy (R) (2/3-3/4 gastrectomy) was done in patients who after maximal stimulation with histamine showed a high acid output (MAO greater than 30 mEa/hr), and a small resection (r) (1/3-1/2 gastrectomy) in low secretors (MAO less than 30 mEq/hr). The material was prospectively controlled by admission to hospital at 3 months, 1 year and 5 years postoperatively. The preoperative values of MAO found in R and r were 42.8 and 21.5 mEq/hr (p less than 0.001), respectively. The postoperative MAO values at the 3-month control were 4.5 and 3.0 mEq/hr by R and r, respectively, which shows that the grading of resection had been successful. Atrophic gastritis increased in frequency from 4% at the time of operation to 72% at the 1-year control...

Topics: Adolescent; Adult; Aged; Anemia; Biopsy; Body Weight; Celiac Disease; Child; Duodenal Ulcer; Female; Folic Acid Deficiency; Follow-Up Studies; Gastrectomy; Gastric Juice; Gastric Mucosa; Gastrins; Histamine; Humans; Male; Middle Aged; Norway; Postgastrectomy Syndromes; Prospective Studies; Recurrence; Work Capacity Evaluation

Topics: Adult; Gastrins; Gastroenterostomy; Humans; Insulin; Insulin Secretion; Middle Aged; Postgastrectomy Syndromes; Pyloric Antrum; Pylorus; Vagotomy; Zollinger-Ellison Syndrome

28 investigations were performed in control patients with no gastric disease (n equals 10), in patients after total gastrectomy (n equals 10) and in patients after duodenopancreatectomy (n equals 8). We measured the serum gastrin concentrations in the fasting state and after the ingestion of a test meal. The results indicate that more than 60% of the gastrin activity is released from extragastric sites and in addition, it is supposed that about 20% are released from extragastric and extraduodenal sites.

Topics: Aged; Digestion; Duodenum; Female; Gastrectomy; Gastrins; Humans; Male; Middle Aged; Pancreatectomy; Postgastrectomy Syndromes; Stimulation, Chemical

1. In a preopertive group of patients suspected of having the Zollinger-Ellison syndrome the serum gastrin and gastric acid response to calcium infusion may be highly diagnostic. 2. In a group of Zollinger-Ellison syndrome patients following total gastrectomy, the gastrin response to calcium infusion correlates well with presence or absence of tumor.

Topics: Calcium; Follow-Up Studies; Gastrectomy; Gastric Juice; Gastrins; Humans; Postgastrectomy Syndromes; Zollinger-Ellison Syndrome

Topics: Afferent Loop Syndrome; Anemia, Macrocytic; Diarrhea; Dumping Syndrome; Folic Acid Deficiency; Gastrectomy; Gastric Juice; Gastrins; Humans; Intestinal Absorption; Intrinsic Factor; Mucus; Osteoporosis; Postgastrectomy Syndromes; Stomach Neoplasms; Vitamin B 12 Deficiency; Vomiting

Topics: Gastrectomy; Gastrins; Gastroscopy; Humans; Jejunum; Peptic Ulcer; Postgastrectomy Syndromes; Pyloric Antrum; Radiography; Secretin; Zollinger-Ellison Syndrome

Topics: Adult; Aged; Chronic Disease; Dumping Syndrome; Duodenal Ulcer; Female; Gastrectomy; Gastric Juice; Gastrins; Gastroscopy; Humans; Hypotension; Male; Middle Aged; Pain, Postoperative; Pentagastrin; Postgastrectomy Syndromes; Pyloric Antrum; Pylorus; Radiography; Stomach; Stomach Ulcer; Tachycardia; Vomiting

Topics: Duodenal Ulcer; Duodenum; Gastrectomy; Gastric Juice; Gastrins; Humans; Methods; Pentagastrin; Postgastrectomy Syndromes; Stimulation, Chemical; Stomach

Topics: Adult; Cardia; Contrast Media; Dumping Syndrome; Duodenal Ulcer; Esophagoscopy; Esophagus; Female; Follow-Up Studies; Gastrins; Gastroesophageal Reflux; Hernia, Hiatal; Humans; Male; Manometry; Middle Aged; Peptic Ulcer; Peristalsis; Postgastrectomy Syndromes; Posture; Radiography; Radioimmunoassay; Stomach Neoplasms

Topics: Adult; Aged; Binding, Competitive; Blood Glucose; Female; Gastric Acidity Determination; Gastric Mucosa; Gastrins; Glucagon; Glucose Tolerance Test; Growth Hormone; Humans; Hypoglycemia; Insulin; Intestine, Small; Liver; Male; Middle Aged; Pancreas; Postgastrectomy Syndromes; Radioimmunoassay; Receptors, Drug

Topics: Animals; Diagnosis, Differential; Gastric Juice; Gastrins; Humans; Injections, Intravenous; Islets of Langerhans; Peptic Ulcer; Postgastrectomy Syndromes; Pyloric Antrum; Radionuclide Imaging; Secretin; Technetium; Zollinger-Ellison Syndrome

The gastric antral mucosa was studied histologically in 22 patients with atrophic gastritis, of whom 11 had high levels and 11 had normal levels of serum gastrin. The antrum was graded histologically from normal to grade 3 gastritis. All patients with hypergastrinaemia (nine seropositive and two seronegative for parietal cell antibody) had either a normal antrum or minimal (grade 1) antral gastritis. In contrast all but one patient without raised serum gastrin (nine seronegative and two seropositive for parietal cell antibody) had severe (grades 2-3) antral gastritis. Thus circulating gastrin levels observed in patients with gastritis and achlorhydria can be directly related to the presence or absence of antral mucosal damage.Comparison of the histological appearances of the antral mucosa with serum gastrin and parietal cell antibody status has provided a basis for the separation of two distinctive forms of atrophic gastritis.

Topics: Achlorhydria; Anemia, Pernicious; Antibodies; Atrophy; Chronic Disease; Gastric Mucosa; Gastrins; Gastritis; Humans; Middle Aged; Postgastrectomy Syndromes; Radioimmunoassay; Stomach

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