Effect of antral instillation of bile salts on fasting serum gastrin levels.

There have been several reports that bile salts instilled into a dog's alkalinized antral pouch cause acid secretion in a denervated fundic pouch. Antral gastrin release was assumed, but serum gastrin levels were not measured. In a randomized crossover study, serum gastrin levels were measured by radioimmunoassay during the infusion of a solution of bile salts (5 mM, pH 5.5, 280 mOsm, 37 degrees C), or an identical saline solution without bile salts, into the pH-controlled (5.5) antrum of 8 volunteers. The mean baseline serum gastrin level (+/- SE) was 18.7 +/- 1.0 and 20.5 +/- 0.9 pg/ml for the bile salt and control periods, respectively (NS). The serum gastrin rose promptly after bile salt infusion, but not after saline. The mean (+/- SE) integrated gastrin response was 81 +/- 17 pg . min/ml during the bile salt infusions, but essentially zero (-3.3 +/- 22 pg . min/ml) during control infusions (P less than 0.02). The 40% rise in serum gastrin in the initial 15-min bile salt period was higher than in the control period (P = 0.016). Thus we have shown, for the first time, an increase in serum gastrin during the antral instillation of bile salts in man. The potential physiologic and/or pathologic importance of this finding has not been established.

RCT Entities:   Population Interventions Outcomes