Circulating gastrin in peptic ulcer disease

Gastric response to meat extract stimulation in patients with gastroduodenal ulcer and patients after vagotomy or antrectomy

Gastric acid secretion basally and in response to intragastric meat extract instillation or to tetragastrin, and circulating gastrin concentration basally and after meat extract stimulation were studied in 67 patients with gastroduodenal ulcer, 30 patients after highly selective vagotomy or selective vagotomy for duodenal ulcer, 12 patients after antrectomy for or gastric ulcer and 10 control subjects. Circulating gastrin concentration increased significantly after meat extract stimulation in control subjects, patients with ulceration and patients after highly selective vagotomy, and acid secretion in each group was increased significantly above basal level. In patients after selective vagotomy, significant increase of circulating gastrin concentration was observed, but it was not associated with significant increase of acid secretion. After antrectomy, neither gastrin nor acid secretion increased significantly after meat extract stimulation. In conclusion, present study suggested that (1) gastric acid secretion in response to intragastric meat extract is chiefly affected by the responsiveness of oxyntic cells and release of antral gastrin and that (2) the presence of the antrum is almost essential for acid secretion after a test meal, and release of duodenal gastrin after antrectomy would not be so potent biologically as to result in an acid secretion.

Action of gastrin on the lower oesophageal sphincter in man

Both hog gastrin and synthetic gastrin stimulate the cardiac sphincter to increase tone and augment the resistance to reflux. Endogenous gastrin has a similar effect, and gastrin also stimulates the secretion of acid which has also been found to increase the resistance of the sphincter, but the effect of gastrin appears to be independent of the secretory stimulus.