Experience with "Sham" feeding as a test of gastric secretion - abstract

Sham feeding by the "chew and spit" method using a hamburger has been carried out on 17 patients with chronic duodenal ulcer before surgery, 20 three months after surgery and 6 one year after surgery. A group of 11 unmatched controls was tested in a similar fashion. The insulin test was carried out at various intervals after surgery on 50 duodenal ulcer patients. The surgery significantly reduced basal acid output (BAO). However, after surgery (as was to be expected), BAO was similar in both the sham fed and insulin groups. Two out of 11 controls and two out of the 17 pre-op group had a minimal response to the sham feeding and another 2 actually had inhibition of secretion, suggesting that perhaps hamburger was not the best choice of meal for these individuals. Apart from the problems of choice of meal in sham feeding, because this test gives the same information as the insulin test and because it is safer and more physiological, we would recommend its use (AU)

The physiology of gastric secretion

The stomach secretes a number of substances, viz: (1)hydrochloric acid; (2) proteolytic enzymes - the pepsin group and gelatinase; (3) the hormone - gastrin; (4) intrinsic factor; (5) mucus; (6) blood group substances; and (7) a variety of anions and cations. The production and secretion of (1) to (5) are controlled according to the requirements of the body. This programme attempts to explain how these substances are produced and the mechanisms which control their secretion. (AU)

The effect of gastric juice on electrolyte transport by the colon - abstract

Replacement of the oesophagus by the colon is a widely accepted method of treatment for neoplasms or benign strictures of the oesophagus. The colon normally plays an important role in the re-absorption of water and electrolytes in the body. In addition, peptic ulceration sometimes occurs in the colonic transplant. It is therefore important to study the effect of gastric juice on the colon. Trained dogs with chronic Pavlov pouches and isolated segments of colon were the experimental model. Gastric juice was collected from the Pavlov pouches. 25ml of gastric juice was instilled into the colon and samples aspirated at intervals over the next 6 hours. The samples were then analysed for sodium, patassium, chloride, bicarbonate, pH and osmolality. This response was compared with that obtained following the instillation of isotonic solutions of HCI, NaCi, mannitol and (NH4)2SO4. The results obtained show that gastric juice was rapidly and effectively buffered by the colon and there was no increase in the production of mucous. Hydrogen ions were absorbed in exchange for sodium and there was no effect on potassium or chloride transport. There was a decrease in the bicarbonate content of colonic samples. There was no evidence of active water transport (AU)