Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh 160 012, India.
Indian J Gastroenterol. 2021 Feb;40(1):50-55. doi: 10.1007/s12664-020-01116-w. Epub 2021 Jan 8.
Caustic ingestion can lead to structural changes in the upper gastrointestinal tract. However, there are limited data on the effect of caustic ingestion on gastric secretion. This study was planned to determine the changes in gastric acid output in patients with caustic ingestion.
It was a prospective study done at a tertiary care center in northern India. Twenty consecutive patients in chronic phase of caustic ingestion were evaluated for the study. The gastric secretory function was estimated in the basal state and following pentagastrin stimulation. These results were compared with normal values for our laboratory.
The mean age of the included patients (n = 20) was 27.35 ± 2.96 years and 14 patients were male. Sixteen (80%) patients had a history of acid ingestion. Patients with caustic ingestion had significantly lower mean gastric acid secretion (0.8 ± 0.4 mEq/h vs. 4 ± 0.4 mEq/h; p < 0.001) compared to controls. After pentagastrin stimulation, the mean gastric juice volume (31.8 ± 6 mL/h vs. 62.3 ± 11.7 mL/h; p < 0.01) and acidity (15.3 ± 5.1 mEq/L vs. 39.6 ± 9.3 mEq/L; p < 0.001) increased in patients with caustic ingestion, but were lower than those in control subjects. Patients with a lower esophageal stricture (n = 6) had decreased maximum acid output (0.62 ± 0.32 mEq/h vs. 6.05 ± 0.55 mEq/h; p < 0.05) compared to patients with stricture in the upper or middle esophagus.
Caustic ingestion is associated with reduced gastric juice volume and acid output. Patients with stricture in the lower one third of the esophagus are at a higher risk of hypochlorhydria compared to patients with stricture in either the upper or middle esophagus.
腐蚀性物质摄入可导致上消化道结构改变。然而，有关腐蚀性物质摄入对胃酸分泌影响的数据有限。本研究旨在确定腐蚀性物质摄入患者胃酸分泌的变化。
这是在印度北部一家三级医疗中心进行的前瞻性研究。对 20 例慢性腐蚀性物质摄入患者进行研究评估。在基础状态和五肽胃泌素刺激后评估胃分泌功能。将这些结果与我们实验室的正常值进行比较。
纳入患者（n=20）的平均年龄为 27.35±2.96 岁，男性 14 例。16 例（80%）患者有胃酸摄入史。腐蚀性物质摄入患者的平均胃酸分泌量显著较低（0.8±0.4 mEq/h 比 4±0.4 mEq/h；p<0.001）。在五肽胃泌素刺激后，腐蚀性物质摄入患者的平均胃液量（31.8±6 mL/h 比 62.3±11.7 mL/h；p<0.01）和酸度（15.3±5.1 mEq/L 比 39.6±9.3 mEq/L；p<0.001）增加，但低于对照组。6 例下段食管狭窄患者的最大胃酸分泌量（0.62±0.32 mEq/h 比 6.05±0.55 mEq/h；p<0.05）低于中上段食管狭窄患者。
腐蚀性物质摄入与胃液量和胃酸分泌减少有关。下段食管狭窄患者发生低胃酸的风险高于中上段食管狭窄患者。
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