AUBF Gastric

• Gastric fluid analysis is important in pernicious anemia, peptic ulcer, Zollinger-Ellison disease.
• Hydrochloric acid is produced by parietal cells, the same cells that produce intrinsic factor.
• Pepsinogen is produced by chief cells and with the action of HCl becomes pepsin.
• Gastrin is produced by G-cells that stimulate parietal cells to produce HCl.
• Zollinger-Ellison disease is characterized by an increased gastrin level and gastric acid hypersecretion.
• The procedure for gastric fluid analysis involves collecting gastric juice for 1 hour in the unstimulated fasting state.
• Gastric tubes used for gastric fluid analysis include Levine tube, Rehfuss tube.
• Total gastric secretion in the first hour is called Basal Acid Output (BAO).
• BAO is usually 4-5 mEq/hr.
• Gastric stimulants include Pentagastrin, Histamine, Histalog (betazole), Alcohols.
• Ewald’s meal is a test meal for gastric fluid analysis, which includes bread and tea or water.
• Boas is a test meal for gastric fluid analysis, which includes oat meal.
• Riegel’s meal is a test meal for gastric fluid analysis, which includes beef steak and mashed potato.
• Introduction of a stimulant followed by another hour of collection is part of the procedure for gastric fluid analysis.
• Total acid secreted in the hour after stimulation is Maximal Acid Output (MAO).
• The ratio BAO/MAO is calculated in gastric fluid analysis.
• Normal BAO/MAO ratio is 2.5, while in pernicious anemia it is 0, in gastric carcinoma it is 1.0, in duodenal cancer it is 5.0, and in Zollinger-Ellison Syndrome it is 18.0.
• Microscopic analysis of gastric fluid includes checking for pus cells/WBC, RBC, yeast cells, bacteria, parasites, and food residues.