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DUODENAL FLUID
ANALYSIS
Crizelda L. Salita, MS, RMT
GASTRIC PHYSIOLOGY
GASTRIC PHYSIOLOGY
measurements
GASTRIC PHYSIOLOGY
2.
3.
4.
2.
3.
GASTRIC PHYSIOLOGY
CHEMICAL COMPOSITION OF GF
1.
2.
3.
4.
5.
HCl
Pepsin
Mucus
Miscellaneous substances: proteins,
enzymes & intrinsic factor
Rennin (in infants)
Gastrin
1.
1.
2.
3.
Peptic ulcer
Zollinger-Ellison syndrome
2.
3.
1.
4.
5.
SPECIMEN COLLECTION OF GF
SPECIMEN COLLECTION OF GF
SPECIMEN COLLECTION OF GF
TUBES
Ewald or Boas tube
Rehfuss tube
Levine tube
TEST MEALS
1. Ewald Test Breakfast
: 40gm bread, 400ml water
: well masticated
2. Dock Test Breakfast
: same as Ewald but uses shredded wheat biscuits
3. Boas Test Breakfast
: 1tbsp rolled oats, 1 qt water
ROUTINE ANALYSIS OF GF
Appearance
Clear to opalescent, pale gray, sl. viscous
Volume
50-75 mL (relative)
Odor
Faintly pungent
Color and presence of other substances (e.g. Mucus)
Microscopic exam
Gastric acidity
INTERPRETATION OF RESULTS
INTERPRETATION OF RESULTS
>1000 pg/mL
Z-E
syndrome
300-800 pg/mL
History
of vagotomy
Atrial G-cell hyperfunction (pseudo Z-E syndrome)
Gastric outlet obstruction
Gastroparesis
Use of acid-lowering medications (protein pump
inhibitors H2 blockers)
Atrophic gastritis
H. pylori infection
Pernicious anemia
Renal failure
DUODENAL FLUID
ENDOSCOPIC RETROGRADE
CHOLANGIOPANCREATOGRAPHY (ERCP)