Digestive system (Digestive juice)/Function/Composition
gastric fluid analysis
1. GASTRIC FLUID ANALYSIS
Gastric Juice
A colorless to grayish or yellowish watery fluid
w/ a low specific gravity secreted by the surface
epithelium, gastric cells and the various glands
of the gastric tract.
Importance of Detection
Diagnosis of gastric diseases and assist in the
selection of therapy i.e. peptic ulcer
It measures the amount of acid produced by a
patient w/ symptoms of peptic ulcer
Diagnosis of Zollinger-Ellison syndrome (adenoma
of Islet of Langerhans) a condition of gastric
hypersecretion produced by a gastrin secreting
tumor of the pancreas
2. Collection of the Specimen
The patient must be in a fasting state for 12 hours
Contamination w/ saliva neutralizes the gastric
acidity therefore it should be prevented.
Time specimen should be collected for the
purpose of comparison
2 Types of Gastric Juice Collection
Using an evacuated tubes:
1.) Levine tube – inserted in the nose (nasal
intubation)
2.) Rehfuss tube – inserted in the mouth ( oral
intubation)
3. Composition
1.) H2O – varying amounts (99 %)
2.) HCl – secreted by the parietal cells w/c provide
acidity for the activation of pepsinogen
3.) Digestive enzyme
pepsin – catalyzes the protein digestion to
proteoses; secreted by chief peptic cells
lipase – fats ( no importance to digestion)
rennin – milk (ability to coagulate caseinogen to
milk)
gastricsin – importance of this enzyme is not yet
known in gastric secretion
4.) Mineral acid – chiefly acid phosphates
5.) Mucus – fd in moderate amts secreted by GOBLET
cells of stomach to prevent autodigestion of stomach
4. Composition
6.) Electrolytes – main electrolytes present is H+;
also present are Na, Cl, P, Ca and Mg
7.) Particles of food – undigested and partly
digested
3 Main Types of Cells Responsible for Gastric
Juice Production
1.) chief or peptic cells – producing the protein-
splitting enzyme pepsin
2.) parietal or oxyutic cells – producing HCl and
intrinsic factor (erythropoietic factor) absence of
w/c leads to pernicious anemia
3.) goblet or mucous secreting cells – producing
mucus for the protection of the mucosa and
lubricates the food.
5. Macroscopic Examination
Volume:
30 – 60 ml
Fasting sample – contains few ml to 50 ml w/ an
average of 30 ml
Color:
Colorless, yellowish or pale gray w/ varying
amounts of mucus and food particles
Abnormalities in Color:
1.) brownish red or coffee color – presence of
large amount of blood.
2.) opaque gray – seen after a test meal
3.) yellow – presence of fresh bile
6. Abnormalities in Color:
4.) greenish – presence of old bile
5.) red – presence of small amount of blood
Odor:
Odorless or maybe slightly sour or faintly pungent
Abnormalities in Odor:
1.) fecal odor – seen in intestinal obstruction or
gastrocolic-fistula
2.) foul or putrid odor – seen in carcinomatous ulcer
3.) alcoholic odor – seen in alcoholic coma, or after alcohol
test meal
4.) ammoniacal odor – seen in case of uremia
5.) rancid odor – due to butyric (fatty acid) and lactic acid
(present in sour milk) indicating stenosis
and fermentation
7. pH or Reaction:
Normally acidic – pH 1.6 to 1.8
High acidity – pH 1.4 or lower
Low acidity – pH 2.0 or 2.8
Euchlorhydria – refers to normal secretion w/ a
pH bet. 1.6 to 1.8
Hyperchorhydria – increase free HCl above
normal around 60 ml i.e. peptic ulcer
Hypochlorhydria – decreased free HCl
i.e. 1.) carcinoma of the stomach
2.) chronic gastritis 3.) gastric syphilis
Achlorhydria – absence of free HCl
i.e. 1.) pernicious anemia
2.) pellagra
3.) advanced gastric cancer
8. Specific Gravity
Varies from 1.001 – 1.010 w/ an average of
1.007
CHEMICAL EXAMINATION
Acid contents of gastric juice are of 2 types:
1.) Free HCl an acid w/ a pH less than 3.5
2.) Combined HCl or organic acid – an acid w/c
combines w/ proteins or protein-like
subs to form protein salts of HCl.
Test for Free HCl
1.) Topfer’s method
2.) Tubeless gastric Analysis –Diagnex Blue
3.) Boa’s method
4.) Gunzberg method
9. MICROSCOPIC EXAMINATION
Normal Structures
1.) yeast cell – small amounts
2.) epithelial cells 4.) bacteria – lesser amounts
3.) starch granules 5.) fat globules
Pathologic Structures
1.) fragments of tissues
2.) rbc
3.) yeast – large amounts
4.) pus cells
5.) muscle fibers
6.) large number of bacteria and maybe seen are:
a.) Sarcinae
