Effect of Bile Salts on Ionic Permeability of Canine Gastric Mucosa During Experimental Shock

Abstract

Intragastric bile salts are associated with a high frequency of gastric mucosal ulcers and erosions when instilled into the canine stomach during hemorrhagic shock. We studied the individual and combined effects of hemorrhagic shock and intragastric bile salts on ionic movement and mucosal injury in the dog. Mean net fluxes per 30 min of H+, Na+, Cl, and K+ after the instillation of HCl alone (160 and 100 mEq per liter) into the distally occluded stomach were not different (P>0.05) in normotensive and shocked animals, and none of these animals developed mucosal lesions. Fluxes of these ions, although increased 3- to 6-fold by the presence of bile salts (10 mm taurocholic acid), were not significantly different in normotensive and shocked animals. However, all animals who had bile salts and acid instilled into the stomach during hemorrhagic shock had large gastric erosions at autopsy. We conclude that ionic movement is not influenced by hemorrhagic shock, and that the production of ulcers in this model is dependent on shock and increased H+ back diffusion from disruption of the gastric mucosal barrier.