Abstract
Gastric acid secretion in response to a protein meal and to exogenously administered synthetic human gastrin 17-I was measured in patients with Barrett's esophagus, patients with uncomplicated gastroesophageal reflux, and normal age- and sex-matched controls. Acid secretion, both basally and in response to gastrin 17-I, was significantly greater in patients with Barrett's esophagus compared to normal individuals without reflux. Basal gastrin levels and meal-stimulated levels of the hormone were similar among all three groups. Sensitivity to gastrin, expressed as the concentration causing half-maximal acid secretion, was also similar among the study groups. It is speculated that elevated basal acid production in Barrett's esophagus may contribute to the pathogenesis of the disorder.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Spechler JS, Goyal RK: Barrett's esophagus. N Engl J Med 315:362–371, 1986
Cameron AJ, Ott BJ, Payne WS: The incidence of adenocarcinoma in columnar-lined (Barrett's) esophagus. N Engl J Med 313:857–859, 1985
Naef AP, Savary M, Ozello L: Columnar-lined lower esophagus: An acquired lesion with malignant predisposition: Report on 140 cases of Barrett's esophagus with 12 adenocarcinomas. J Thorac Cardiovasc Surg 70:826–835, 1975
Spechler SJ, Robbins AH, Rubins HB: Adenocarcinoma and Barrett's esophagus: An overrated risk? Gastroenterology 87:927–933, 1984
Sjogren RW Jr, Johnson LF: Barrett's esophagus: a review. Am J Med 74:313–321, 1983
Iascone C, DeMeester TR, Little AG, Skinner DB: Barrett's esophagus: Functional assessment, proposed pathogenesis, and surgical therapy. Arch Surg 118:543–549, 1983
Holloway RH, Dobbs WJ: Esophageal motor function in Barrett's esophagus.In Barrett's Esophagus: Pathophysiology, Diagnosis, and Management. SJ Spechler, RK Goyal (eds). New York, Elsevier Science, 1985, pp 105–112
Meyer W, Vollmar F, Bar W. Barrett-esophagus following total gastrectomy: A contribution to its pathogenesis. Endoscopy 11:121–126, 1979
Reid BJ, Haggitt RC, Rubin CE, Rabinovitch PS: Barrett's esophagus: Correlation between flow cytometry and histology in detection of patients at risk for adenocarcinoma. Gastroenterology 93:1–11, 1987
Maxwell V, Eysselein VE, Kleibeuker J, Reedy T, Walsh JH: Glucose perfusion intragastric titration. Dig Dis Sci 29:321–326, 1984
Johnson LF, DeMeester TR: Twenty-four hour pH monitoring of the distal esophagus: A quantitative measure of gastroesophageal reflux. Gastroenterology 63:325–332, 1974
George JD: New clinical method for measuring the rate of gastric emptying: The double sampling test meal. Gut 9:237–242, 1968
Rosenquist GL, Walsh JH: Radioimmunoassay of gastrin.In Gastrointestinal Hormones. Jerzy Glass (ed). New York, Raven Press, 1980, pp 769–795
Blair AJ, Richardson CT, Walsh JH, Chew P, Feldman M: Effect of parietal cell vagotomy on acid secretory responsiveness to circulating gastrin in humans: Relationship to postprandial serum gastrin concentration. Gastroenterology 90:1001–1007, 1986
Halvorsen JF, Semb BKH: The Barrett syndrome (the columnar-lined lower esophagus): An acquired condition secondary to reflux esophagitis, a case report with discussion of pathogenesis. Acta Chir Scand 141:683–687, 1985
Bremner CG, Lynch VP, Ellis FH Jr: Barrett's esophagus: Congenital or acquired?: An experimental study of esophageal regeneration in the dog. Surgery 68:209–216, 1970
Hamilton SR: Pathogenesis of columnar cell-lined (Barrett's) esophagus.In Barrett's Esophagus: Pathophysiology, Diagnosis, and Management. SJ Spechler, RK Goyal (eds). New York, Elsevier Science, 1985, pp 29–37
Wesdorp ICE, Bartelsman J, Schipper MEI, Tytgat GN: Effect of long-term treatment with cimetidine and antacids in Barrett's oesophagus. Gut 22:724–727, 1981
Castell DO: Medical management of the patient with Barrett's esophagus.In Barrett's Esophagus: Pathophysiology, Diagnosis, and Management. SJ Spechler, RK Goyal (eds). New York, Elsevier Science, 1985, pp 199–209
Patel GK, Clift SA, Schaefer RA, Read RC, Texter EC Jr: Resolution of severe dysplastic changes with regression of columnar epithelium in Barrett's esophagus on medical treatment. Gastroenterology 82:1147, 1982
Saltzman M, Barwick K, McCallum RW: Profession of cimetidine-treated reflux esophagitis into a Barrett's stricture. Dig Dis Sci 27:181–186, 1982
Author information
Authors and Affiliations
Additional information
Study supported by Smith, Kline, and French, Inc.
Rights and permissions
About this article
Cite this article
Mulholland, M.W., Reid, B.J., Levine, D.S. et al. Elevated gastric acid secretion in patients with Barrett's metaplastic epithelium. Digest Dis Sci 34, 1329–1334 (1989). https://doi.org/10.1007/BF01538064
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01538064