Correlative Study: Gastric Secretion and Histology

Abstract

Summary A correlative study of gastric secretions and gastric mucosal histology was performed in 81 patients undergoing maximal histamine-stimulated gastric analysis and peroral gastric mucosal biopsy. The volume of gastric juice and output of acid for the first 30 min following histamine was studied in all 81 patients. In 56 of these patients, the first 30-min specimen was dialyzed, lyophilized, and studied for weight, output of proteolytic enzyme activity, hexose, and vitamin B12-binding materials. Vitamin B12 absorption was tested in 27 patients by the urinary excretion test of Schilling. On the basis of histology, the patients were divided into four groups: normal, superficial gastritis, gastritis with atrophy, and gastric atrophy. Patients with superficial gastritis and little apparent glandular atrophy had marked reduction in volume, weight of gastric juice solids, and in output of acid and proteolytic enzyme activity. The output of hexose and B12-binding materials was similar to that of patients with normal gastric mucosa. With more severe mucosal lesions showing varying degrees of overt atrophy, a further decrease in all of the measured parameters of gastric secretion was noted, including output of hexose and B12-binding materials. Patients with gastritis and atrophy secreted very small amounts of either acid or proteolytic enzymes or both. Patients with complete glandular atrophy were found to secrete small volumes of concentrated juice lacking in acid and proteolytic enzyme activity, yet containing small amounts of vitamin B12-binding materials and having a high concentration of hexose. Vitamin B12 absorption was normal in all patients except those with gastric atrophy, despite the fact that patients having gastritis and partial glandular atrophy produced very little vitamin B12-binding materials.