GASTRIC FUNCTION TESTS In some diseases of Stomach & Duodenum alterations in gastric secretion occurs, thereby chemical examination

of gastric contents has limited but specific value in diagnosis & assessment of disorders of upper GIT. Hence to get complete data of gastric function, the contents of stomach should be examined During resting period During digestion after meals After stimulation Gastric juice secreted in 24 hrs is about 1500 ml to 2000ml. Chief constituents of Gastric juice HClParietal cells / oxyntic cells - it activates the zymogen pepsinogen to pepsin by partial proteolysis, also helps in absorption of iron and calcium. Pepsinogen..........Chief cells - Pepsins act on proteins and polypeptides & cleave peptide bonds adjacent to aromatic amino acids Gastrin: hormone secreted by G cells, stimulates secretion of HCl. Vit B 12

Intrinsic Factor: secreted Parietal cells, is a glycoprotein required for absorption of Gastric lipase: Chief cells. Act on Triglycerides, convert to Fatty acids and Rennin : is seen in infants but not in adults. Alkaline Mucus

glycerol

Indications of Gastric Function Tests To diagnose Gastric Ulcers To exclude the diagnosis of Pernicious Anaemia & Peptic ulcer in Pt with GU. For the diagnosis of Zollinger Ellison Syndrome To determine the completeness of Surgical Vagotomy. CLASSIFICATION OF GFTs Analysis of Resting contents(Gastric Residuum) Fractional Test Meal Analysis Analysis after Stimulation # Alcohol stimulation # Caffeine stimulation # Histamine stimulation # Augmented Histamine test # Insulin stimulation # Pentagastrin test Tubeless Gastric Analysis Other relevant tests are estimation of Sr.Gastrin, Sr.Pepsinogen levels, Tests for Occult blood and Tests for H.Pylori

Analysis of resting contents: 1) Volume : 20-50ml after a night fast

> 100-120 ml.is abnormal Increased Volume in. - Hypersecretion of Gastric juice - Retention due to delayed emptying - Regurgitation of duodenal contents.

2) Consistency : 3) Colour:

Fluid, should not contain food residues. yellow/green..

Clear/ Colourless/ slight

Bright red / dark red / brownabnormal dark brown seen in bleeding gastric ulcer, coffee ground appearance seen in Ca stomach. 4) Bile: Small amounts are insignificant, but increased in Intestinal Obstruction / Ileal Stasis. 5) Mucus: in small amounts, increased in gastritis , Ca Stomach.

6) Free & Total Acidity: determined by titrating a portion of the sample with a standard solution of NaOH. Free acidity measures only HCl, Topfers reagent is used as indicator. Total acidity includes HCl and other organic acids , Phenolphthalein is used as indicator