Tubeless research methods stomach
Despite, that probe (fractional) method of research currently offers the most extensive information on the activity of the stomach, He nefiziologichen and burdensome for patients. Discomfort in probing may change the activity of the gastric glands, therefore provides the use of tubeless methods, which are easily tolerated by patients. However, they are less accurate and gives indicative information. They should be used in cases, when there are contraindications to the probe research. By diseases, where spending is contraindicated enteral study of gastric secretion, include narrowing of the esophagus, aneurysm aortы, marked dysfunction of the circulatory system and other, accompanied by the dire state of the body, as well as the preceding (up to 2 weeks) bleeding from the stomach or intestines, etc.. d.
Desmoidnaya sample
Desmoidnaya sample, proposed Sali, currently used relatively rarely, as an indicative test for the detection of achlorhydria. During the tests the acidity of the urine was evaluated by staining with methylene blue, introduced into the stomach in a special pouch, tied with catgut.
The thin elastic rubber tie 0,15 g methylene blue catgut thread number 5, One end of the thread is inserted into the unit to prevent bonding rubber. The ends are cut short. The diameter of the prepared bag should be no more than 5 mm. Thereafter bags are washed with water and allowed to 24 h for leak testing. Water staining blue means, that not enough bags are sealed and are not suitable for the study. In the absence of staining the water can be considered, that the bag is tied properly and ready for use.
The patient swallows desmoid bag on an empty stomach before breakfast. For the study were collected through three servings of urine 3, 5 and 20 no. Solyanaya acid and pepsin digested catgut, the bag is opened, Methylene Blue is absorbed into the blood and excreted in the urine. Determine the time of occurrence and intensity of the color of urine. In normal acid secretion of gastric glands first portion of urine stained, the second has a pale green, and the third - an intense blue-green color. When hyperchlorhydria painted all urine sample, at a reduced secretion - only the third portion. If the urine is not painted achlorhydria.
The application is recommended for desmoid sample mass of research and identifying individuals with achlorhydria with contraindications to the Sensing, sometimes as a control with treatment, especially in children.
Desmoid trial modification C. B. Korostovtseva It is as follows. Through 1 hours after dinner the patient swallows a bag of rubber, comprising 0,1 g methylene blue, tightly tied catgut and carefully pre-washed. Urine, Highlight of the night, collect. Staining its blue color indicates the presence of gastric juice and free hydrochloric acid, pepsin, the latter being digested catgut. If urine is colorless, even after boiling (when heated identified colorless compound methylene blue), You can think of achlorhydria.
Desmoid trial modification C. T. Maseviča It makes it possible to determine the rate of digestion and catgut thread, thus, indirectly, to judge the degree of proteolytic activity of gastric juice research saliva for the presence of iodine. The sample can be used in patients with lesions of the urinary organs. As an indicator used potassium iodide, which is released into the saliva where, when the bag is opened as a result of the digestion of gastric juice catgut. After 20 minutes after swallowing a bag of potassium iodide patient begins to collect saliva. Normally, iodine appears in saliva 35-45 min (revealed starch). The appearance of the indicator at a later date may indicate a decrease in the digestive ability of gastric juice.
A sample with an ion exchange resin (acidotest) It is, that the gastric pH no higher 3.0, t. it is. in the presence of gastric juice free hydrochloric acid, dye (indicator) released from the ion exchange resin saturated with them - test dragees. Freed indicator evacuated from the stomach into the intestine, absorbed and excreted in the urine. The color intensity is directly proportional to urine pH of gastric contents; more pronounced staining indicates strong acidity. Time indicator appears in the urine depends mainly on the evacuation function of the stomach and the processes of absorption in the gut.
M. F. Lengyel and H. P. Lyashenko proposals Colorimetric method for the quantitative evaluation of the content of the colorant in the urine through 1,5 and 3 hours after the application of the test- drop. This method allows us to investigate basal and stimulated gastric secretion. The level of acidity of gastric contents is estimated (via medical colorimeter) in terms of optical density. On the evacuation function of the stomach can be seen at a rate of evacuation, which is determined by the ratio of the absorbance of urine, obtained during basal and stimulated secretion of food stimulus.
In healthy people, the acidity of the basal secretion of urine color intensity in arbitrary units of optical density is from 0,02 to 0,25, stimulirovannaya secretion pishtevoy razdrazhitely - from 0,25 to 0,38, and at submaximal stimulation of histamine - from 0,35 to 0,5.
In normal evacuation function of the stomach the color intensity of both portions of urine is not very different. Coefficient of evacuation during the basal secretion of 1.0-1.5, when stimulated in response to the food irritability 1.5-2.0. When pilorospazme dye retained in the stomach, isolation in the urine is delayed, the color intensity of the second portion exceeds the first by more than two times.
With the accelerated evacuation of food from the stomach into the duodenum evacuation of at least factor 1,0. The high coefficient of evacuation at normal and low acidity can indicate not so much about delayed gastric emptying, as an inert type of hydrochloric acid secretion of gastric parietal cells. Factor evacuation over 3,0 observed in a compensated state strongly- and mildly stomach and delayed evacuation. When decompensation stomach contents rapidly to the duodenum, in this case, the evacuation rate below 2,0.
Studies of the functional state of the stomach above techniques identify variations in basal secretion of counts in the diagnosis predyazvennyh states and peptic ulcer disease. Research during the stimulated secretion can determine the acidity, and diagnose functional and true achlorhydria.
Although the method of determining acidity with saturated ion exchange resins (acidotest) It is indicative, the value of its recognition by all the authors emphasized achlorhydria. There are cases of detection probe method using stimuli weak and medium strength achlorhydria, whereas atsidotest indicates the presence of free hydrochloric acid. When applied to stimulate the gastric glands histamine achlorhydria increases the accuracy of recognition.
The use of ion exchange resins suitable for the determination of gastric acidity in patients with absolute contraindications for sensing, and at mass studies.
Radionuclide method of investigation of gastric contents
Promising in the diagnosis of diseases of the stomach and duodenum is radionuclide method. With the help of radioactive cobalt can judge the absorption in the stomach cyanocobalamin - Vitamin B12 (and its derivatives - cobalamin) and the development of intrinsic factor. In the study of this method showed a correlation between the decrease in absorption of cobalamin and acid-forming function of the stomach down, supports the view that the development of intrinsic factor and hydrochloric acid with the same cells.
Established, that the lack of reabsorption of cyanocobalamin (Vitamin B12) and its derivatives is observed not only in individuals B12-deficiency anemia, but in some patients atrophic gastritis, and gastric cancer. Gastric digestive ability can be determined using labeled proteins.
Radio telemetry study
Radio telemetry study of the function of the stomach by means of a special swallowed radiopill, fixed in the stomach for fine silk yarn. With radiopill can determine the concentration of hydrogen ions (pH), pressure and temperature in the lumen of the alimentary canal. Radiotelemetricheskiy physiological method, it allows to carry out research under, as close to the natural. With radiopill recorded just emerged (primary) acidity, so the performance of its higher, than study titrimetry method. Radio telemetry study has some advantages over factional study gastric function.
