Журнал "Гастроэнтерология" Том 57, №2, 2023
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Biochemical indicators of gastric juice in hiatal hernia
Авторы: Halinska A.M., Halinskyi O.O., Prolom N.V.
SI “Institute of Gastroenterology of the National Academy of Medical Sciences of Ukraine”, Dnipro, Ukraine
Рубрики: Гастроэнтерология
Разделы: Медицинские форумы
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The purpose: to determine the peculiarities of gastric secretion activity in patients with hiatal hernia.
Materials and methods. Biochemical studies of gastric juice (GJ) were conducted in 23 patients with hiatal hernia (HH) who were undergoing inpatient treatment at the SI “Institute of Gastroenterology of the National Academy of Medical Sciences of Ukraine”. GJ samples were collected during endoscopic examination. pH, pepsin concentration, and total glycoprotein concentration were determined using the methods described by Rudenko et al. (2004). Ca2+ concentration was measured using the standard kit (“Philisit-Diagnostics”). The obtained results were statistically processed on a personal computer using licensed software packages, Microsoft Excel, employing paired comparisons. Differences were considered significant at p < 0.05.
Results. In patients with HH, it was found that the volu–me of gastric juice available for endoscopic collection avera–ged (5.86 ± 0.48) mL. Gastric contents were predominantly acidic, with a pH level of 3.66 ± 0.29, which was 46 % higher than the reference group value of (2.51 ± 0.35) (p < 0.05). Pepsin concentration remained within reference values, at (0.78 ± 0.10) mg/mL, indicating preserved functional acti–vity of the chief cells of the gastric glands. An increase in total glycoprotein concentration by 55 % (p < 0.05) compared to reference values was observed. Considering the frequent association of HH with pylorospasm, this may be a functional response of the surface epithelial cells to prolonged exposure to aggressive factors in the gastric juice.
Considering that the imbalance of Ca2+ concentration can disrupt the processes of neuromuscular transmission and muscle contraction in the digestive tract and may contribute to the development of dyskinesia in the upper parts of the digestive tract, as well as affect the weakness of the diaphragm muscles, it was found that in patients with HH, the concentration of Ca2+ in the gastric juice was (1.02 ± 0.13) mmol/L, which was 51 % lower (p < 0.01) compared to intact data ((2.1 ± 0.1) mmol/L).
Conclusions. It was established that in patients with HH, the main indicators characterizing the aggressiveness of gastric juice remained within normal limits, accompanied by an increase in mucosal protection factors and a decrease in Ca2+ concentration. Further prospective research is needed to investigate changes in the aforementioned indicators in saliva and to differentiate characteristic changes regarding types of HH.