CONTRAINDICATIONS TO GASTRIC ANALYSIS
- Gastric intubation for gastric analysis is contraindicated in esophageal stricture or varices, active nasopharyngeal disease, diverticula, malignancy, recent history of severe gastric hemorrhage, hypertension, aortic aneurysm, cardiac arrhythmias, congestive cardiac failure, or non-cooperative patient.
- Pyloric stenosis: Obstruction of gastric outlet can elevate gastric acid output due to raised gastrin (following antral distension).
- Pentagastrin stimulation is contraindicated in cases with allergy to pentagastrin, and recent severe gastric hemorrhge due to peptic ulcer disease.
Gastric analysis is not a commonly performed procedure because of following reasons:
- It is an invasive and cumbersome technique that is traumatic and unpleasant for the patient.
- Information obtained is not diagnostic in itself.
- Availability of better tests for diagnosis such as endoscopy and radiology (for suspected peptic ulcer or malignancy); serum gastrin estimation (for ZE syndrome); vitamin assays, Schilling test, and antiparietal cell antibodies (for pernicious anemia); and tests for Helicobacter pylori infection (in duodenal or gastric ulcer).
- Availability of better medical line of treatment that obviates need for surgery in many patients.
- Burtis CA, Ashwood ER (Eds). Tietz Fundamentals of Clinical Chemistry, 4th ed. Philadelphia: WB Saunders Co, 1996.
- Drossman DA, Shaheen NJ, Grimm IS (Eds). Handbook of Gastroenterologic Procedures (4th Ed). Philadelphia: Lippincott Williams and Wilkins, 2005.
- Rosenfeld L. Gastric tubes, meals, acid, and analysisrise and decline. Clin Chem 1997;43:837-42.
- Wallach J. Interpretation of Diagnostic tests (7th Ed). Philadelphia. Lippincott: Williams and Wilkins, 2000.
- Wolfe MM, Soll AH. The physiology of gastric acid secretion. N Engl J Med 1988;319:1707-14.
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