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Gastrointestinal Function
Gastrointestinal Function
FUNCTION
THE STOMACH
Gastric Function Test
Gastric Secretion
Gastric secretion occurs in response to •
:various stimuli
Neurogenic impulses from brain transmitted •
by means of vagal nerves (responsees to the
sight or smell of food)
Distention of stomach of stomach with food or •
.fluid
Gastric Secretion
Contact of protein breakdown products terms •
secretagogues, with gastic mucosa
Gastrin hormone stimulates gastric secretion, •
it is a polypeptide secreted by specialised G
cells in the gastric antrum and duodenum in
response to vagal stimulation and contact
with secretagogues
Factors influencing Gastrin Hormone
Secretion
Measurement of Gastrin –
Fasting Level in Zollinger-Ellison exceeds –
1000pg/mL to up to 400000 pg/mL
Gastrin level may slighly increase in –
• B) Gastrin production:
• Gastrin is a polypeptide released by gastric
antrum and duodenum and is a potent stimulator
of gastric acid production.
• Its release is inhibited by low gastric pH , and its
circulating levels are increased in patients with
chronic hypochlorhydria.
• So, plasma gastrin may be elevated in cases of
decreased HCL production in the stomach such
as due to gastritis, treatment with H2
antagonists, proton pump inhibitors, pernicious
anemia or previous vagotomy.
• Zollinger-Ellison syndrome
• This syndrome is due to a gastrinoma, that is,
neoplasia may be due to either:
• a) pancreatic gastrin-producing cells (common)
• b) gastric gastrin-producing cells
• About 60% of gastrinomas are malignant and 30%
occur as part of the MEN syndrome type 1.
• Increased gastrin production leads to chronic
hypersecretion of gastric acid, which in turn causes
peptic ulceration and sometimes diarrhea and fat
malabsorption leading to steatorrhoea.
• The steatorrhoea is believed to be due to
inhibition of pancreatic lipase by the high [H+}
concentration in the intestinal lumen.