Gastric Acid Secretion and Gut Hormone Release in Patients with Crohn's Disease

Kouhei Fukushima, Iwao Sasaki, Hiroo Naito, Michinaga Takahashi, Yuji Funayama, Yasuhiko Kamiyama, Chikashi Shibata, Takashi Doi, Hideo Segami, Akihiro Iwatsuki, Noriya Ohtani, Seiki Matsuno

First Department of Surgery, Tohoku University School of Medicine

Thirty patients with Crohn's disease who were admitted to our department for surgical treatment were examined regarding gastric acid secretion stimulated by tetragastrin and release of gut hormones such as gastrin, GIP, and total-GLl after test meal loading. The mean MAO of these patients was significantly increased before the operation. MAO and PAO correlated with the length of the small intestinal lesions and the resected segment of the small intestine. Widespread lesions and resection of 100 or more centimeters of the small intestine were associated with increased acid output. Patients with Crohn's disease showed lower gastrin, GIP, and total-GLl levels in the fasting and postprandial state than the control. Immunohistochemical study with anti-glycentin antibody revealed a loss of positive cells in severe lesions of the ileum resected from Crohn's patients for surgical therapy. These results indicate that careful attention to gastric hypersecretion is necessary for the patients with Crohn's disease who have widespread lesions of the small intestine before and after surgery. We speculate that decrease of enterogastrone such as enteroglucagon may cause gastric acid hypersecretion in Crohn's patients.

Key words
Crohn's disease, gastric acid secretion, gut hormone

Reprint requests
Kouhei Fukushima First Department of Surgery, Tohoku University School of Medicine
1-1 Seiryo-machi, Aoba-ku, Sensai, 980 JAPAN

Accepted
September 4, 1991

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