Gastric Analysis 125j1s

FRACTIONAL GASTRIC ANALYSIS USING TEST MEAL

METHOD OF CARRYING OUT THE TEST •Introduction of Ryle’s tube in stomach of a

fasting patient (overnight) •Removal of residual gastric contents &its analysis. •Ingestion of test meal. •Removal of 5to6ml gastric contents after meal.

TEST MEALS • EWALD TEST MEAL • 2 pieces of toast (35g) • 250 ml of light tea.

•OAT MEAL :• 2 tablespoonful of oat meal • 1 quart of boiling water

• RIEGEL MEAL:• 200 ml of beef broth • 150g boiled beef steep • 100 g Smashed potatoes.

COLLECTION OF SAMPLE: At intervals of exactly 15 minutes about 10 ml of gastric contents are removed by means of syringe attached to the tube.

GRAPHICAL REPRESENTATION OF NORMAL PERSON’S ACIDITY

DIFFERENT CONDITIONS • Hyperchlorhydria • Hypochlorydria • Achlorhydria

Hyperchlorhydria This occurs when the maximum free acidity exceeds 45 mEq/l, combined acid remains the same as in normal persons.

CAUSES OF HYPERCHLORHYDRIA i. Duodenal ulcer ii. Gastric ulcer iii. Gastric carcinoma iv. Jejenal & Gastro Jejunal ulcers. v. Hyperirritablity vi. Chronic appendicities vii. Gastric neurosis viii. Chronic cholecystitis

HYPOCHLORHYDRIA Low acidities are found.

CAUSES Carcinoma of stomach Pernicious Anaemia

ACHLORHYDRIA • This term is used when there is no

secreation of HCl, but enzyme like pepsin is present. • Achlorhydria can be differentiated from hypochlorhydira by stimulation test with histamine. • Histamine stimulation shows rise in free HCl in hypochlorhydria, but not in achlorhydria.

CAUSES OF ACHLORHYDRIA • • • •

Carcinoma of stomach Chronic gastritis Partial Gastrectomy Microcytic Hypochromic anaemia

ANALYSIS OF GASTIC- JUICE FREE & TOTAL ACIDITY •

REGENTS REQUIRED:– – – –

Gastric Juice N/10 NaOH Phenolphthalein Indicator Topfers Rgt.

CHEMICALS REQUIRED:• • • • • • •

Conc. HCl Glacial Acetic Acid Sodium Hydroxide Phenolphthalein Topfers Rgt. Ethanol Methyl orange

REQUIREMENTS 1. Gastric Juice

-

1000ml

2. N/10 Sodium Hydroxide- 4 gms of NaOH in 1000ml D.W. 3. Topfers Regt. – pH 2.9-4.0 4. Phenolphthalein – 1g in 95% ethanol pH 8.3-10.0 5. Methyl orange – pH 2.9-4.6

ANALYSIS OF ACIDITY:The gastric juice is analyzed for free, total and combined acidity by using titration method.

FIRST TITRATION:• Take 5ml of gastric juice • Add 2-3 drops of topfers Regt. as indicator • Mix it • Take 0.01N NaOH and titrate until a light yellowish orange colour appear. • Note the initial and final reading • This gives us free acidity

SECOND TITRATION:• To the titrated solution add 2-3 drops of

phenolphthalein indicator and continue to titrate with 0.01N NaOH until the light pink colour appears. • Note the total volume of NaOH added • This gives the total acidity

EXPRESSION OF RESULTS Results has been expressed as 0.01N HCl/ 100ml gastric contents

TEST FOR OCCULT BLOOD • Reagents required – 1pinch of benzidine powder – 3-4 drops of G.A.A – 0.5ml of H2O2 – Mix

PROCEDURE Take few ml of gastric juice and then add few drops of above solution RESULT Blue colour shows occult blood

LACTIC ACID 1ml of filtered gastric sample, 1-2 drops of 10g /dl FeCL3 RESULT Yellow colour shows presence of lactic acid

STARCH Few drops of gastric sample + few drops of iodine RESULT Blue Colour

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