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What is the significance of doing a pentagastrin stimulation and fasting serum gastrin level test ?

A 45-year-old store manager complained of a burning, gnawing pain, moderately severe, almost always in the epigastric region. The pain is absent when he awakens, appears in mid-morning, and is relieved by food but recurs two to three hours after a meal. The pain often awakens him at 1 or 2 am. An endoscopic examination and x-ray studies with barium showed normal stomach function but the presence of duodenal ulcers . Gastric analysis demonstrated that the gastric juice pH fell to 1.9 with pentagastrin stimulation (6 ug/kg s.c.). Fasting serum gastrin levels were normal. Recommended treatments for this individual are: Antacids: 15 - 30 mL of liquid or two to four tablets one to three hours after each meal and at bedtime for six weeks Histamine (H2) receptor antagonists: cimetadine (300 mg) or ranitidine (150 mg) with each meal and at bedtime for four to eight weeks. Questions: 1. What is the diagnosis of this individual? 2. What is the significance of doing a pentagastrin stimulation test? 3. What is the significance of doing a fasting serum gastrin level? 4. What is the function of antacids? 5. How do the H2 antagonists work to treat this disorder? WHat type of dietary and behavioral recommendations would also be suggested for this person?
Asked On : Wed, 18 Apr 2012
Answers:  1 Views:  960
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General & Family Physician 's  Response
hi,here is your answer;
1.diagnosis is peptic ulcer disease.
2.penagastrin test is done to see the response of gastric glands for acid secretion, it also rules out atrophic gastritis, carcinoid syndrome and even medullary carcinoma thyroid which can together constitute MEN syndrome.
3.fasting gastrin level are raised in gastrinoma or zollinger ellison syndrome but it is not raised in peptic ulcer disease.
4.antacids neutralises gastric acid and increases gastric ph , it may reduce gastric acid secretion by gastric glands.
5.H2 antagonist block histamine receptor in the parietal cells and thus decreases gastric acid secretion.

bland small diet feed every 3 hour during waking period, tea and coffe should be avoide or should be taken with ample of milk, avoid fried, spicy foods, chillies, pickle, sour fruits, raw vwgwtables, alcohol, smoking and tobacco chewing. avoid NSAIDs.
Answered: Thu, 3 Apr 2014
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