FRACTIONAL GASTRIC ANALYSIS USING TEST MEAL

METHOD OF CARRYING OUT THE TEST

Introduction of Ryles tube in stomach of a

fasting patient (overnight) Removal of residual gastric contents &its analysis. Ingestion of test meal. Removal of 5to6ml gastric contents after meal.

TEST MEALS
EWALD TEST MEAL
2 pieces of toast (35g) 250 ml of light tea.

OAT MEAL : 2 tablespoonful of oat meal 1 quart of boiling water

RIEGEL MEAL: 200 ml of beef broth 150g boiled beef steep 100 g Smashed potatoes.

COLLECTION OF SAMPLE: At intervals of exactly 15 minutes about 10 ml of gastric contents are removed by means of syringe attached to the tube.

GRAPHICAL REPRESENTATION OF NORMAL PERSONS ACIDITY

DIFFERENT CONDITIONS
Hyperchlorhydria Hypochlorydria Achlorhydria

Hyperchlorhydria
This occurs when the maximum free acidity exceeds 45 mEq/l, combined acid remains the same as in normal persons.

CAUSES OF HYPERCHLORHYDRIA
i. Duodenal ulcer ii. Gastric ulcer iii. Gastric carcinoma iv. Jejenal & Gastro Jejunal ulcers. v. Hyperirritablity vi. Chronic appendicities vii. Gastric neurosis viii. Chronic cholecystitis

HYPOCHLORHYDRIA
Low acidities are found.

CAUSES
Carcinoma of stomach
Pernicious Anaemia

ACHLORHYDRIA
This term is used when there is no
secreation of HCl, but enzyme like pepsin is present. Achlorhydria can be differentiated from hypochlorhydira by stimulation test with histamine. Histamine stimulation shows rise in free HCl in hypochlorhydria, but not in achlorhydria.

CAUSES OF ACHLORHYDRIA

Carcinoma of stomach Chronic gastritis Partial Gastrectomy Microcytic Hypochromic anaemia

ANALYSIS OF GASTIC- JUICE FREE & TOTAL ACIDITY

REGENTS REQUIRED: Gastric Juice N/10 NaOH Phenolphthalein Indicator Topfers Rgt.

CHEMICALS REQUIRED:
Conc. HCl Glacial Acetic Acid Sodium Hydroxide Phenolphthalein Topfers Rgt. Ethanol Methyl orange

REQUIREMENTS
1. Gastric Juice
1000ml
2. N/10 Sodium Hydroxide- 4 gms of NaOH in 1000ml D.W. 3. Topfers Regt. pH 2.9-4.0 4. Phenolphthalein 1g in 95% ethanol pH 8.3-10.0 5. Methyl orange pH 2.9-4.6

ANALYSIS OF ACIDITY:The gastric juice is analyzed for free, total and combined acidity by using titration method.

FIRST TITRATION: Take 5ml of gastric juice Add 2-3 drops of topfers Regt. as indicator Mix it Take 0.01N NaOH and titrate until a light
yellowish orange colour appear. Note the initial and final reading This gives us free acidity

SECOND TITRATION: To the titrated solution add 2-3 drops of

phenolphthalein indicator and continue to titrate with 0.01N NaOH until the light pink colour appears. Note the total volume of NaOH added This gives the total acidity

EXPRESSION OF RESULTS
Results has been expressed as 0.01N HCl/ 100ml gastric contents

TEST FOR OCCULT BLOOD

Reagents required
1pinch of benzidine powder 3-4 drops of G.A.A 0.5ml of H2O2 Mix

PROCEDURE
Take few ml of gastric juice and then add few drops of above solution RESULT Blue colour shows occult blood

LACTIC ACID
1ml of filtered gastric sample, 1-2 drops of 10g /dl FeCL3 RESULT Yellow colour shows presence of lactic acid

STARCH
Few drops of gastric sample + few drops of iodine RESULT
Blue Colour

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