A study on pH values in the remnant stomach by capsule method
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概要
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An easy and dependable assessment of the gastric acidity using a telemetering capsule has been proved to be a new field of gastric function tests. The gastric acidity in the remnant stomachs was measured by the pH capsule in 100 patients, 26 of whom were known to have stomal ulcers. Gastric secretion was stimulated by subcutaneous use of tetragastrin (4μg/Kg) and potassium bicarbonate was loaded for neutralization. In 14 cases pH values were recorded by both intubation and capsule method.The results obtained were as follows:1) The capsule test is a more physiologic testing method of the gastric juice in comparison with the conventional tubing method, and acid secretion measured by the tube suction method is considered to be less reliable as for the gastric remnants.2) During the immediate postoperative periods, pH in the remnant stomach fell into two groups, namely pH below 3.0 and pH above 5.1. But it gradually shifted into individual proper pH and stabilized in 6 months and thereafter.3) About 90% of the patients showed fall of pH value in the remnant stomachs by loading 4μg/Kg of tetragastrin and the lowest values in 30 to 40 minutes following the potassium bicarbonate loading.4) In the group in which gastrin responses were good, most of the patients had basal pH values less than 3.0. It was these patients who had postoperative complaints.5) The acid content of the remnant stomachs was approximated by measuring amount of potassium bicarbonate reqired to raise pH over 4.0 in 45 minutes following gastrin loading. Free acid in the remnant stomachs was below 0.25mEq in the non-stomal ulcer group.6) All 26 cases with the stomal ulcers had basal pH less than 2.0 and they were symptomatic. The ulcers were solitary in nature and were classified Ul III to IV. The majority of the ulcers were located in the efferent loops. Only two patients had the ulcers in the remnant stomachs.7) Medical treatments relieved symptoms in the half of these patients with stomal ulcers, but no permanent decrease of the acid secretion would be attained by the medical treatments. Therefore, surgical intervention will be required in the appropriate time.
- 財団法人 日本消化器病学会の論文
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関連論文
- I-31. 教室における胃・十二指腸潰瘍穿孔症例と術後残胃内 pH に関する検討(第3回日本消化器外科学会大会)
- カプセルによる消化管内テレメータリング : その臨床応用について
- A study on pH values in the remnant stomach by capsule method