This is a study to build up a technical procedure for taking gastric juice via gastroscope and measuring pH on 438 patients with gastro-duodenal erosion or ulcer at Bac Giang General Hospital. Results: the technique of taking gastric juice by leading the tip of gastroscope in the “liquid puddle” and then sucking gastric juice through biopsy canal by a syringe of 100ml had been 94.6% successful; this technique is simple and easy to do. Measuring pH of gastric juice on 363 patients with gastro-duodenal erosion or ulcer found no patient with pH<1; over 80% of them were found with gastric juice pH 1 to 3; pH of gastric juice has no relation with age and sex
Peptic Ulcer ; Gastric Acid

No abstract available.
Gastric Acid* ; Proton Pump Inhibitors*

No abstract available.
Eating* ; Gastric Mucosa* ; Hydrochloric Acid* ; Mucous Membrane*

OBJECTIVETo study the precise cause and the specific procedure about gastric mucosal lesion in rats with water immersion-restraint stress(WRS).

METHODSOne hundred and forty-four Wistar rats were divided into 9 groups randomly: A, B, C, D, E, F, G, H and I group. There were 16 rats in each group. A, B and C groups underwent gastric emptying determination. Emptying rate of gastric fluid was determined with radiate nuclide (99m)Tc. D, E and F groups underwent gastric acid secretion determination after cleaning gastric contents and pylorus ligation. G, H and I groups underwent gastric acid secretion determination after pylorus ligation without cleaning gastric contents. Gastric mucosal lesion ulcer index(UI) was evaluated. The relationship between of gastric mucosal lesion and gastric emptying rate and gastric acid secretion were examined.

RESULTSGastric emptying rate decreased obviously when the WRS time was prolonged. There were significant differences among B (WRS 2 h), C group (WRS 4 h) and A group (controlled group) (P<0.01). There was also significant difference between B and C group (P<0.01).The rats' gastric acid secretion was inhibited significantly. The differences among E (WRS 2 h), F (WRS 4 h) and D groups (controlled group) were significant (P<0.01). There was no significant difference between F and E groups (P>0.05). The gastric mucosal lesions were aggravated with time of stress. Gastric contents cleaning could effectively prevent gastric mucosal lesions originated by stress .The operation had no influence on this test. There were significant gastric mucosal lesion UI in B and C groups compared with A group (P<0.01). The difference between B and C group was significant (P<0.01).There were no gastric mucosal lesions in A, D, E, F and G groups. However, There was significant difference between I and F group (P<0.01). No significant difference were found among A, D, E, F and G groups (P>0.05). There were significant difference between H and B group and also between I and C group (P<0.01).

CONCLUSIONSWRS can induce gastric emptying disturbance, reduce gastric acid secretion and cause gastric mucosal lesion. As a factor inducing gastric mucosal lesion, acid can damage gastric mucosa as long as it exists without necessary peracid. The prolongation of acid with gastric mucosa contact period and the decrease of gastric mucosa resistance are perhaps the major causes of gastric mucosal lesion. Besides anti-acid, giving facilitative gastric emptying drugs and gastric lavage during stress ulcer prevention and cure should be considered. Acid evacuation in time is also a major cure for gastritis and recurrent ulcer.

Animals ; Gastric Acid ; secretion ; Gastric Emptying ; Gastric Mucosa ; pathology ; Male ; Rats ; Rats, Wistar ; Stress, Physiological

Brunner's gland hamartomas are rare, benign duodenal tumors. But, they are the commonest hamartomas in the small intestine and believed to represent hyperplasia of Brunner's glands, perhaps in response to excessive gastric acid secretion. Brunner's gland hamartomas are usually smaller than 1cm and asymptomatic, incidental finding during endoscopy or radiographic examination. We report a case of large Brunner's gland hamartoma which prolapsed into gastric antrum and caused gastric outlet obstruction, and was resected by endoscopic polypectomy.
Brunner Glands ; Endoscopy ; Gastric Acid ; Gastric Outlet Obstruction* ; Hamartoma* ; Hyperplasia ; Incidental Findings ; Intestine, Small ; Pyloric Antrum

Bezoars are conglomerates of vegetable fiber and hair, or concretions of various substances located in the stomach or the intestinal tract. They are classified as phytobezoar, trichobezoar, trichophytobezoar, and concretion. It is shown that the decrease in secretion of pepsin and gastric acid and the delay in gastric emptying might contribute to the formation of bezoars. This case describes the rare complication of the jejunal perforation due to a postgastrectomy bezoar.
Bezoars* ; Gastrectomy ; Gastric Acid ; Gastric Emptying ; Hair ; Intestinal Perforation ; Pepsin A ; Stomach ; Vegetables

Although our present knowledge of the etiology of peptic ulcer is incomplete, the presence or absence of peptic ulcer is determined by the delicate interplay between aggressive factors (secreted gastric acid and pepsin) and defensive factors (mucosal resistance). Peptic ulcer is produced when the aggressive effects of acid-pepsin dominate the protective effects of gastric or duodenal mucosal resistance by predominance of aggressive factors or interruption of defensive factors. KU-54 enhances mucosal resistance to tissue injury by the increase of gastric mucosal blood flow, the stimulation of gastric mucosal metabolism, the increase of glycoprotein of gastric mucus, and the increase of ATP of gastric mucosa. We have treated 38 cases of gastric ulcers with KU-54 300 mg daily for 4-12 weeks for the evaluation of the therapeutic efficacy. Endoscopic, clinical, and laboratory assessments were undergone before and after 4 ~ 12 weeks of the treatment. Major symptoms of gastric ulcer have been improved in 83.3% after the medication with KU-54. The healing rate of gastric ulcer evaluated by endoscopy was observed in 33.3% after 4 weeks, 73.3% after 8 weeks, 76.6% after 12 weeks of the medication with KU-54. The utility rate of KU-54 was 86.7%. We could conclude that KU-54 is the utilizable drug for gastric ulcer.
Adenosine Triphosphate ; Endoscopy ; Gastric Acid ; Gastric Mucosa ; Glycoproteins ; Metabolism ; Mucus ; Peptic Ulcer ; Stomach Ulcer*

BACKGROUND: Aspiration pneumonitis is one of the most severe anesthetic complications. The severity of this complication is associated with the acidic nature of aspirated gastric juice. H2 receptor antagonists inhibit gastric acid secretion and elevate the gastric juice pH. The purpose of this study was to compare the effects of preoperative night cimetidine, ranitidine and famotidine medications on gastric volume and pH. METHODS: We studied 84 healthy patients, ASA physical status I or II, who were each randomly allocated to one of 4 groups. Group I ingested only 200 ml of milk up to 8 10 hours prior to anesthesia. Groups II, III and IV ingested 200 ml of milk and 400 mg of cimetidine, 150 mg of ranitidine and 20 mg of famotidine, respectively, on the evening before elective surgery. After the induction of anesthesia, gastric juice was collected with 18 French Salem sump tube, and gastric volume and pH were measured. RESULTS: There were no significant differences in gastric juice volume among the numbers of the 4 groups. However, Group IV (famotidine) showed a significant high pH, compared with the other groups. CONCLUSIONS: Famotidine 20 mg, which is premedicated on the evening before elective surgery, is more effective in preventing aspiration pneumonitis than cimetidine 400 mg and ranitidine 150 mg.
Anesthesia ; Cimetidine* ; Famotidine* ; Gastric Acid ; Gastric Juice ; Humans ; Hydrogen-Ion Concentration* ; Milk ; Pneumonia ; Premedication* ; Ranitidine*

BACKGROUND: Aspiration pneumonitis is one of the most severe anesthetic complications. The severity of this complication is associated with the acidic nature of aspirated gastric juice. H2 receptor antagonists inhibit gastric acid secretion and elevate the gastric juice pH. The purpose of this study was to compare the effects of preoperative night cimetidine, ranitidine and famotidine medications on gastric volume and pH. METHODS: We studied 84 healthy patients, ASA physical status I or II, who were each randomly allocated to one of 4 groups. Group I ingested only 200 ml of milk up to 8 10 hours prior to anesthesia. Groups II, III and IV ingested 200 ml of milk and 400 mg of cimetidine, 150 mg of ranitidine and 20 mg of famotidine, respectively, on the evening before elective surgery. After the induction of anesthesia, gastric juice was collected with 18 French Salem sump tube, and gastric volume and pH were measured. RESULTS: There were no significant differences in gastric juice volume among the numbers of the 4 groups. However, Group IV (famotidine) showed a significant high pH, compared with the other groups. CONCLUSIONS: Famotidine 20 mg, which is premedicated on the evening before elective surgery, is more effective in preventing aspiration pneumonitis than cimetidine 400 mg and ranitidine 150 mg.
Anesthesia ; Cimetidine* ; Famotidine* ; Gastric Acid ; Gastric Juice ; Humans ; Hydrogen-Ion Concentration* ; Milk ; Pneumonia ; Premedication* ; Ranitidine*

BACKGROUND: Delayed gastric emptying occurs frequently in diabetic patients. The aim of this study was to investigate preoperative gastric acidity and volume in parturients with gestational diabetes mellitus (GDM) undergoing elective cesarean delivery. METHODS: Twenty-five full term gravid women with GDM (GDM group) and another twenty-five without any complication (control group) were recruited. Before the anesthesia, a 14-F multiorifice nasogastric tube was inserted and the gastric contents were directly aspirated. RESULTS: There were no differences in the aspirated gastric pH and volumes between the groups (2.6 pH with 29.9 ml in the control group vs. 2.5 pH with 29.8 ml in the GDM group). The numbers of patients at-risk for aspiration, pH < 2.5 and volume > 25 ml in the two groups were similar (9/25, 36% in the GDM group, 7/25, 28% in the control group). CONCLUSIONS: Diabetes does not increase the risk of aspiration pneumonitis compared to the normal pregnant women in elective cesarean delivery.
Anesthesia ; Diabetes, Gestational ; Female ; Gastric Acid ; Gastric Emptying ; Humans ; Hydrogen-Ion Concentration ; Pneumonia ; Pregnancy ; Pregnant Women*