The indices of histamine-stimulated gastric secretion
Histamine is one of the strongest stimulators of gastric secretion, causing sub-maximal and maximum histamine secretion, depending on the dose. A direct relationship between the mass of functioning lining cells and the rate of hydrochloric acid was noted after maximum histamine stimulation. The decrease in the number of functioning lining cells is reflected, respectively, on the volume of acid secretion. Histamine is used to differentiate organic achlorhydria, which depends on atrophic changes in the gastric mucosa, and functional, associated with inhibition of gastric secretion. The reference values of the main indices of gastric secretion with histamine stimulation are given in Table.
Table Reference values of the main indices of basal, submaximal and maximal gastric secretion during histamine stimulation [Fiszon-Riss Yu. I., 1972]
Table Reference values of the basic indices of basal, submaximaland maximum gastric secretion with histamine stimulation [Fiszon-Riss Yu. I., 1972]
If hydrochloric acid is detected in a study with histamine stimulation in gastric juice,then achlorhydria, previously detected by sounding without the use of histamine, is regarded as functional. With organic achlorhydria, free hydrochloric acid does not appear after the administration of histamine. Organic chlorhydria is accompanied by Addison-Birmer anemia, atrophic gastritis and stomach cancer. Functional achlorhydria is possible in many pathological processes, accompanied by suppression of gastric secretion, in some cases can be a reaction to self-probing.
A simple and double histamine test( subcutaneous administration of a solution of histamine hydrochloride at a dose of 0.08 ml / kg) refers to the methods of submaximal stimulation of gastric secretion. At the maximum histamine test of Caye, a solution of histamine dihydrochloride from 0.024 mg / kg was injected subcutaneously.30 minutes before the administration of histamine, 2 ml of a 2% chloropyramine solution is administered to prevent the toxic effect of the histamine.
Microscopic examination. Microscopically examine the portion of gastric juice obtained on an empty stomach: Normally find the nucleus of leukocytes and a small number of epithelial cells. A large number of intact leukocytes and epithelial cells are characteristic of achlorhydria. Single red blood cells can appear in the gastric juice as a result of a trauma of the gastric mucosa with a probe. A significant number of erythrocytes can be found in peptic ulcer of stomach, ulcerated stomach cancer.