[Endoscopy of the upper gastrointestinal tract: changes in the concentration of vasoactive intestinal polypeptide and gastrin?].

The report of a significant increase in plasma VIP concentration (PVC) during endoscopy of the upper gastrointestinal tract prompted us to examine this question under comparable experimental conditions, with simultaneous determination of serum gastrin concentration (SGC). Thirteen patients took part in a study wherein PVC and SGC were determined before, during and after oesophagogastroduodenoscopy (OGD). Before OGD the value for PVC was 30 +/- 2.5 pg/ml (means +/- SEM); during endoscopy it tended to increase slightly, to 35 +/- 3.2 pg/ml immediately after the examination (p greater than 0.05). By contrast with this finding, the SGC increased rapidly and significantly from 47 +/- 4.7 pg/ml prior to the examination to maximal values up to 68 +/- 6 pg/ml on inspection of the fundus (p less than 0,005), and was at a significantly increased level (p less than 0.05), with a value of 61.5 +/- 7.2 pg/ml, as much as thirty minutes after the examination. Sixty minutes after the examination the values had fallen to their original level (47.5 +/- 7.5 pg/ml). The present study shows that OGD has no significant influence on PVC, but that it is possible that stimulation of the VIP-ergic system is accompanied by a trivial increase in PVC. By contrast with this OGD significantly increases the concentration of endocrinally secreted gastrin, an effect which lasts as much as thirty minutes after the examination. The release of gastrin is a result of the combined effect of mechanical stimulation, distension due to insufflation of air and simultaneously induced neural influences. However, these mechanisms exert at most an insignificant influence on PVC - if indeed they have any effect on it at all.