1999
DOI: 10.1046/j.1365-2036.1999.00543.x
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Post‐prandial intragastric and duodenal acidity are increased in patients with chronic pancreatitis

Abstract: Median intraduodenal and intragastric pH are not significantly decreased in patients with chronic pancreatitis and exocrine insufficiency but the postprandial time with an acidic pH in the duodenum (pH < 5) and in the stomach (pH < 3) is significantly (P

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Cited by 19 publications
(10 citation statements)
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“…The secretion of bicarbonate, which maintains an alkaline pancreatic juice, is dramatically reduced in most patients [380]. In addition, during the post-prandial period, the pH of the stomach and the upper small intestine is significantly decreased [381]. When postprandial pH in the small intestine becomes 4 or lower, bile acids precipitate and digestive enzymes (lipase in particular) lose their activities.…”
Section: Resultsmentioning
confidence: 99%
“…The secretion of bicarbonate, which maintains an alkaline pancreatic juice, is dramatically reduced in most patients [380]. In addition, during the post-prandial period, the pH of the stomach and the upper small intestine is significantly decreased [381]. When postprandial pH in the small intestine becomes 4 or lower, bile acids precipitate and digestive enzymes (lipase in particular) lose their activities.…”
Section: Resultsmentioning
confidence: 99%
“…If extrapolated to the situation seen in vivo, this could mean that an appreciable fraction of the enzymes would be released already in the stomach with the risk of denaturation as the gastric pH falls with meal-induced acid secretion, thus reducing the efficacy of the enzyme substitution. In one study, pH was monitored simultaneously in the stomach and duodenum of patients with chronic pancreatitis; the time it took for the stomach to reach a pH of less than 3 after a meal, and the duodenum to reach a pH of more than 5, was found to be 15-24% longer than in controls [25]. These findings highlight the significance of the stability of the pancreatic enzymes at a pH of less than 5, as provided by some, but not all, of the enzyme supplements.…”
Section: Discussionmentioning
confidence: 97%
“…45 Apart from the dose of fatty acids delivered to the duodenum, fatty acid chain length has a major influence on pancreatic enzyme response: glycerol did not influence enzyme secretion, increasing fatty acid chain length augmented pancreatic responses. 58 Accordingly, medium chain triglycerides administered to the proximal jejunum did not increase enzyme secretion in contrast to equicaloric amounts of long chain fatty acids. 86 Furthermore, the terminal carboxy group of the fat molecule appears to be of importance because oleic acid had a much stronger stimulatory effect on pancreatic secretion than oleyl alcohol.…”
Section: Enzyme Secretionmentioning
confidence: 91%