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Gastric Hypersecretory States: Investigation and Management

  • Stomach (C Howden, Section Editor)
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Opinion statement

Hypersecretory conditions affecting the stomach account for significant morbidity and mortality manifested in some cases with peptic ulcer, gastrointestinal hemorrhage, and/or gastroesophageal reflux disease (GERD). The diagnosis of gastric acid hypersecretory states can be challenging and relies on the use of quantitative assays to measure gastric acid secretion and serum gastrin. The most common etiology for hypergastrinemia is the use of potent gastric acid inhibitors such as the proton pump inhibitors. The differential diagnosis of this condition is of critical importance, and will dictate management decisions. Conditions such as atrophic gastritis are relatively benign and can lead to hypergastrinemia without the presence of gastric acid hypersecretion. Zollinger-Ellison syndrome, on the other hand, causes hypergastrinemia with profound gastric acid hypersecretion [1]. More common causes of hypergastrinemia include gastric outlet obstruction, ileus, and chronic renal failure [2]. In most cases, proton pump inhibitors will be used to manage these conditions. In some instances, surgical therapy may be required. This chapter will review the important clinical causes of gastric acid hypersecretion and provide insights to the best medical management options to better care for patients with these disorders.

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Acknowledgments

This work received grant support from the Department of Veterans Affairs RR&D Merit Review (JRP); Human Studies CORE through CURE: Digestive Diseases Research Center supported by NIH grant P30DK41301; NIH NIDDK T32 NIH# is 5T32DK07180 (JNB).

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Conflict of Interest

Jennifer Phan declares that she has no conflict of interest.

Jihane N. Benhammou has a patent, VIP Measurement of Hypergastrinemia, pending.

Joseph R. Pisegna has received speaker fees from Takeda and has a patent, VIP Measurement for Hypergastrinemia, pending.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. Department of Medicine, David Geffen School of Medicine, Los Angeles, CA, USA

    Jennifer Phan MD, Jihane N. Benhammou MD & Joseph R. Pisegna MD

  2. Division of Digestive Diseases, David Geffen School of Medicine, Los Angeles, CA, USA

    Jihane N. Benhammou MD & Joseph R. Pisegna MD

  3. Division of Gastroenterology, Hepatology and Parenteral Nutrition, Department of Medicine, Department of Veterans Affairs, VA Greater Los Angeles Healthcare System Los Angeles, Los Angeles, CA, 90073, USA

    Jihane N. Benhammou MD & Joseph R. Pisegna MD

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  1. Jennifer Phan MD
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Correspondence to Joseph R. Pisegna MD.

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Phan, J., Benhammou, J.N. & Pisegna, J.R. Gastric Hypersecretory States: Investigation and Management. Curr Treat Options Gastro 13, 386–397 (2015). https://doi.org/10.1007/s11938-015-0065-8

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