Abstract
Proton pump inhibitors block the H+/K+-ATPase enzyme, and thus increase gastric pH to ensure healing of duodenal and gastric ulcers. However, this increased pH is also the optimal pH for salivary and pancreatic amylase activity in gastric juice. This study aimed to correlate any relevant patient and drug history with a-pancreatic and total amylase activity in gastric juice samples.The Reflotron was used to analyze pancreatic, salivary and total a-amylase in gastric juice. For each sample, a blank, a diluted and spiked sample were analysed as internal method control. Gastric juice samples were obtained from patients attending the Endoscopy Unit at the General Hospital and receiving PPIs (n=41), and those not on such therapy (controls, n=59).
Pearson correlation showed a positive relationship between pH and amylase activity (p-value <0.05). Two-sample t-tests, indicated that control patients have a significantly lower pancreatic and total amylase activity, when compared to patients on PPIs (p-values <0.05). Patients on PPIs diagnosed with GORD or hiatus hernia had the highest activity of salivary amylase, whilst patients diagnosed with gastritis and duodenitis had the highest activity of pancreatic amylase in their gastric juice. Patients on different PPIs had different amylase activities, however this difference was not significant at the 0.05 criterion.
Gastric injury observed in PPI patients might not be a direct result of amylase activity. Other components found in gastric juice should be investigated for their potential to cause mucosal damage. Knowledge of the relation between gastric pH, gastric amylase activity and pathology can lead to an improved understanding of gastric function.
| Date of Award | 29 Nov 2013 |
|---|---|
| Original language | English |
| Supervisor | Lilian Azzopardi (Promotor) & Anthony Serracino-Inglott (Promotor) |
Keywords
- Gastirc Acid
- Proton Pump Inhibitors
- Gastroscopy