Effect of Medical and Surgical Vagotomy on Intrinsic Factor Secretion

Adams, Janey; Cox, Alan G.; Kennedy, Elizabeth H.; Thompson, J.C.

doi:10.1136/bmj.3.5563.473

Cited by 10 publications

(2 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The first is that it is possible that the proximal gastritis which develops after a vagotomy may be a progressive change which will eventually lead to severe atrophic gastritis in a large proportion of the patients. This would explain previous findings that intrinsic factor secretion and vitamin B12 absorption are diminished after vagotomy (Cox et al, 1964;Bitsch et al, 1966;Adams et al, 1967). There is also the possibility that atrophic gastritis is a precancerous lesion.…”

Section: Discussionmentioning

confidence: 56%

Gastritis duodenitis, and circulating levels of gastrin in duodenal ulcer before and after vagotomy.

Meikle¹,

Taylor²,

Truelove³

et al. 1976

Gut

View full text Add to dashboard Cite

SUMMARY Biopsy specimens have been taken from five standard sites in the stomach and from the duodenal bulb in order to investigate the association of gastritis and duodenitis with duodenal ulcer. Twenty patients with chronic duodenal ulcer were investigated in this manner and in addition had gastric secretion tests and a radio-immune assay of serum gastrin under differing conditions. The patients were then treated either by a truncal vagotomy and pyloroplasty (TVP) or by a highly selective vagotomy without a drainage procedure (HSV). All the investigations were repeated three months postoperatively. Duodenal ulcer was usually associated with gastritis, although this varied in extent and severity from patient to patient. In nearly all the patients, gastritis was present at the pyloric end of the stomach and along the lesser curve. In more than half of the patients, gastritis was also present in the body of the stomach but the fundus was usually spared. Chronic duodenitis was found in the duodenal bulb in all these patients. After vagotomy there was a marked increase in both the extent and severity of the proximal gastritis in both treatment groups but the distal gastritis remain almost unchanged. There was little change in the incidence of duodenitis after vagotomy but its severity was lessened. No correlation was found between the peak acid output (PAO) in response to Histalogandthe severity ofthe gastritis or the duodenitis either before or after operation, with one exception. The postoperative PAO was significantly less in those patients who developed a severe proximal gastritis after vagotomy. No relationship was found between the severity of the distal gastritis and the levels of serum gastrin. No correlation was found between either the basal or peak acid output and the corresponding serum gastrin levels before or after vagotomy.The gastritis and duodenitis associated with a chronic peptic ulcer have received comparatively little study by the modem method of obtaining multiple biopsy specimens under vision through a fibreoptic endoscope. Our principal object in the present study was to determine the extent and severity of any gastritis or duodenitis in a group of patients with chronic duodenal ulcer who had already been selected for surgical treatment and to determine the effects of two types of vagotomy on the mucosa of the stomach and duodenal bulb. In addition, we set out to determine the levels of circulating gastrin in these patients in response to various stimuli, both before and after operation, and to relate these levels to gastric acid output and to the histological state of the mucosa.Received for publication 11 June 1976 Methods PATIENTS Twenty patients attending the Radcliffe Infirmary with chronic duodenal ulcer who had already been selected for surgical treatment were studied shortly before operation and three months postoperatively. Ten of the patients were treated by bilateral truncal vagotomy combined with a Heinicke-Miculicz pyloroplasty (TVP) and the other 10 by a highly selective vag...

show abstract

Section: Discussionmentioning

confidence: 56%

Gastritis duodenitis, and circulating levels of gastrin in duodenal ulcer before and after vagotomy.

Meikle¹,

Taylor²,

Truelove³

et al. 1976

Gut

View full text Add to dashboard Cite

show abstract

“…Consequently, this study gives support to the theory that acid and intrinsic factor are reduced in the same magnitude by disturbance of the vagal function. A d a m et al (1) expressed the view that medical vagotomy does not affect the intrinsic factor reduction in the same way as surgical vagotomy. Thcy proposed that the vagal component in the control of intrinsic factor secretion might be less dominant than the vagal component in the regulation of acid output.…”

Section: Acta Tned Scand 192mentioning

confidence: 99%

Intrinsic Factor Secretion Following Pentagastrin and Insulin Stimulation in Diabetes Mellitus

Langer

Dotevall

Walan

1972

Journal of Internal Medicine

View full text Add to dashboard Cite

In 10 patients with diabetes of long duration, most of them exhibiting late manifestations of the disease, and in a control group the intrinsic factor secretion has been studied after stimulation with pentagastrin and insulin. The responses to pentagastrin were similar in the two groups, indicating that there was no serious destruction of the gastric mucosa. On the other hand the secretory response differed after insulin stimulation. In the diabetic group the response was about 4/10 of the pentagastrin response, the corresponding proportion in the control group being about 9/10. This discrepancy is interpreted as a manifestation of diabetic neuropathy.

show abstract

Intrinsic factor secretion after vagotomy

Meikle¹,

Bull²,

Callender³

et al. 1977

Journal of British Surgery

View full text Add to dashboard Cite

The intrinsic factor (IF) output during basal and Histalog-stimulated gastric secretion has been estimated in two series of patients with chronic duodenal ulcer before and 3 months or more after treatment by either highly selective vagotomy or truncal vagotomy and pyloroplasty. The effects of the two different vagotomy operations appear to be virtually identical and each produced significant reductions in intrinsic factor secretion after Histalog stimulation. This confirms the view expressed by previous workers that it is the vagotomy as such which is responsible, excluding the drainage procedure from any possible role. Furthermore, as these results were demonstrated 3 months after operation, it is likely that the depressed IF secretion is a permanent feature and one which, it is postulated, may become progressively more severe. In both series there is a marked reduction in IFoutput during the second hour of stimulated gastric secretion, indicating an early wash-out of preformed IF. This persists after vagotomy.

show abstract

Effect of Medical and Surgical Vagotomy on Intrinsic Factor Secretion

Cited by 10 publications

References 5 publications

Gastritis duodenitis, and circulating levels of gastrin in duodenal ulcer before and after vagotomy.

Gastritis duodenitis, and circulating levels of gastrin in duodenal ulcer before and after vagotomy.

Intrinsic Factor Secretion Following Pentagastrin and Insulin Stimulation in Diabetes Mellitus

Intrinsic factor secretion after vagotomy

Contact Info

Product

Resources

About