The hormone gastrin is secreted in the stomach. Gasterin - description of the drug, instructions for use, reviews. Treatment for elevated gastrin levels

One of the hormones that is responsible for the proper functioning digestive system, is gastrin. It is produced by G-cells of the stomach, and in not in large numbers mucous small intestine and pancreas. The task of gastrin is to increase the release of hydrochloric acid, as well as pepsins, to ensure a normal digestive process.

The main purpose of the stomach is to break down the nutrients that have entered it so that the body can use them as a building material or provide itself with the necessary energy. To do this, it produces gastric juice and digestive enzymes, which are responsible for the normal course of the digestive process.

Among the components that are part of the gastric juice and which are affected by gastrin, hydrochloric acid is isolated (during food processing, the acidity is 1.5 to 2 pH, which is enough to dissolve the plastic), as well as pepsins, which are enzymes designed to break down food proteins to peptides.

By themselves, pepsins are passive, but under the influence of hydrochloric acid they are activated, and they act only in the stomach: as soon as they, together with food, are in small intestine are neutralized.

Features of gastrin

Under the influence of gastrin, gastric juice becomes acidic enough to cope with the processing of food. There are three main forms of this hormone, which got their name due to the amino acid residues contained in the molecule:

• gastrin-14 (half-life 5 minutes);
• gastrin-17 (half-life 5 minutes);
• gastrin-34 (half-life 42 minutes).

The first two forms are produced by the stomach, while the third (34) is a prohormone. It is synthesized by the pancreas, after which it is under the influence of food and parasympathetic nervous system converted to gastrin-17.

Gastrin is activated under the influence of incoming food and such reflex factors as stretching of the stomach after food enters it, exposure to nerve stimuli, insulin, histamine, adrenaline, calcium.

When activated, the hormone binds to receptors that respond to it, which leads to an increase in the secretion of hydrochloric acid, pepsins and creates the level of acidity necessary for food processing in the stomach. At the same time, gastrin inhibits the delivery of food to the small intestine, allowing acid and pepsins to process the incoming substances as much as possible.

In order for the stomach to successfully cope with the task, gastrin increases the synthesis of prostaglandin E, which causes the expansion of blood vessels in the digestive organ, improved blood supply and the transition to the mucous membrane of leukocytes, which produce enzymes, and also capture and digest solid particles. To protect the walls of the stomach from acid, the hormone stimulates the production of biocarbonates and mucus, which protect the mucosa from the influence of aggressive elements.

Gastrin also prepares the body for the next stage of digestion, which occurs in the small intestine, by stimulating the synthesis of the hormones somatostatin, secretin, cholecystokinin, peptides and enzymes in the pancreas and intestines.

As soon as the production of these hormones and some other elements increases to a certain amount, the concentration of gastrin begins to decrease. This leads to a decrease in the acidity of the stomach after the passage of food into the intestines, and provides the empty organ with a state of rest.

Diagnosis of hormone levels

If you suspect problems with the digestive system, the doctor prescribes a blood test, one of which will have to determine the level of gastrin in the blood. The doctor makes a diagnosis based on the interpretation of the data from this and other tests.

If the tests showed that the level of gastrin in the blood is elevated, this indicates the following ailments:

• Zollinger-Ellison syndrome is a potentially malignant tumor of the pancreas that synthesizes the production of gastrin, which leads to stomach ulcers and duodenum;
• Overgrowth of G-cells of the stomach;
• Pyloric stenosis is a complication of a stomach ulcer, when the lumen in the digestive tract narrows, which disrupts the passage of food from the stomach to the intestines;
• Vagotomy without resection of the stomach is a surgical operation that consists in dissecting the main trunk or branch of the vagus nerve without removing the stomach;
• Chronic atrophic gastritis - under the influence of the disease, a change in the mucous membrane occurs, and atrophy of the stomach with growth connective tissue in place of normal glands;
• Pernicious anemia is anemia.

Also, an increase in gastrin in the blood can be triggered by chronic renal failure, cancer, or stomach ulcers. In patients with chronic atrophic gastritis, the risk of developing cancerous tumors is high, in order to determine the disease in time, doctors recommend periodically taking tests. Sometimes the increase in the level of the hormone is affected by stress, which leads to the activation of the stomach (the result is ulcers and gastritis).

Decreased secretion of gastrin is observed after gastrectomy, which is surgical operation, as a result of which the stomach is completely removed (usually with malignant tumor). Also, analyzes can show reduced gastrin synthesis in hyperthyroidism, when thyroid begins to produce iodine-containing hormones in excess of the norm.

The treatment regimen that the doctor prescribes to normalize the level of gastrin largely depends on the cause that provoked malfunctions in the body. If it is the thyroid gland, attention will need to be paid to restoring its functions. To treat gastritis, you need to follow a diet and take medications prescribed by your doctor. At oncological disease surgery is required.

Gastrin is a hormone that is carried by the blood and has a direct effect on the functioning of all and systems. human body.

The gastrointestinal tract is no exception.

Since many are wondering - gastrin, what it is, it is recommended to look at the materials in this section.

After reading this section, you will learn about such a hormone in the human body as gastrin.

Get an idea of ​​what it means to increase or decrease its content, as well as diagnostic tests to identify various diseases organs, the presence of which is indicated by its amount in human blood.

This hormone is produced by the pyloric glands, which are located at the junction of the stomach to the small intestine. The release of gastrin begins to occur when the pylorus is stretched, as well as when food is broken down, which occurs due to the action of chemical stimuli.

Gastrin is responsible for the following processes in the gastrointestinal tract:

• enables normal bile secretion
• stimulates secretion of pancreatic juice
• produces gastric juice
• improves the functioning of both the stomach itself and the gallbladder and the entire intestine

The blood level of this hormone can change significantly. It is least of all in the time interval from three in the morning to seven in the morning. During the day, its amount is the largest, especially after meals.

• The amount of this hormone in the blood directly depends on the level of hydrochloric acid in the stomach. The less it is contained in, the greater the level of gastrin observed in it.

Via laboratory research, according to these indicators, it is possible to determine the acidity of gastric juice, which can be increased or decreased, and also to determine the presence of chronic gastritis.

More often, lab tests on gastrin are carried out to detect a disease such as Zollinger-Ellison syndrome.

A large amount of gastrin secreted at the same time leads to an increase in the secretion of hydrochloric acid by the stomach, which causes ulcers in the stomach.

The main signs of its increased content include:

• regular pain arising in upper region belly
• weight loss, body weakness
• the occurrence of eructation of acidic contents or air
• regular and loose stools
• the appearance of pain in the digestive tract

Before passing such analyzes, certain preparation should be carried out:

• Tests should be performed on an empty stomach. After the last meal and before the study should be at least 12 hours.
• You can smoke, drink coffee, tea or juice at least an hour before the test.
• The day before the study, it is necessary to exclude alcohol from your diet. In addition, physical activity should be reduced.
• Analyzes should be carried out before admission or, at least two weeks after the end of the course of their administration.
  5. Immediately before the procedure, it is recommended to relax and calm down. You can lie down and lie down for a bit.

But all of the above signs are characteristic not only for Zollinger-Ellison syndrome, but also for many other diseases of the gastrointestinal tract, for example, peptic ulcer.

By determining the levels of gastrin in the blood, it is possible to identify ulcers in the intestine and stomach. This can be done due to the fact that the natural source of its release is the food in the stomach, as well as the stretching of the walls of the stomach.

If a person has a stomach ulcer, the level of gastrin in the blood will be elevated regardless of whether the person was eating or his stomach was empty. In the case of a duodenal ulcer, the level of this hormone on an empty stomach will be within the normal range, and after taking it, it will increase.

The amount of gastrin in the blood may decrease after such surgical intervention like removal of the vagotomy and pylorus, which stimulate the production of gastrin.

Also, its decrease in the blood can occur with increased thyroid function. For this reason, a low content of gastrin in the blood becomes an appointment for diagnosing the condition of the thyroid gland.

However, many factors can influence the accuracy of the result of such studies and they are not always accurate.

For example, such tests, when carried out in older people, can show the presence of a high content of this hormone, while high level in the blood, gastrin, in fact, is a decrease in the production of hydrochloric acid by the body, as a result of the natural aging process.

Laboratory diagnostics for the level of gastrin in the blood must be carried out on an empty stomach, otherwise the diagnostic results will be erroneous. High levels of gastrin can also occur in diseases such as pyloric stenosis, chronic kidney failure, pernicious anemia and stomach cancer.

The hormone gastrin is a substance that can stimulate the process of digestion. Insufficient or excessive amount of it provokes the development of many diseases. gastrointestinal tract. The level of gastrin is very important in diagnosing the patient's condition, since in this way it is possible to determine the best tactics for treating the identified pathologies.

The secretion of gastrin more takes over the stomach. This process occurs in its pyloric region with the help of G-cells. Also, the release of the hormone occurs in the duodenum and pancreas, but in much smaller quantities. The secretion of gastrin hormone occurs directly in circulatory system person.

This substance can reside in the body in three of its natural forms. There are large, small and minigastrins, each of which consists of 34, 17 and 14 amino acids, respectively. These substances have a similar structure and chemical structure. Their certain part, consisting of five amino acids, is active. It is able to bind to special gastrin receptors. That's why synthetic analogue This substance (called pentagastrin) consists of only five amino acids.

Functional purpose

Such a hormone, after being isolated by specific cells, binds to gastrin metabotropic receptors located in the stomach. As a result of this process, a stimulating effect on the activity of adenylate cyclase is observed. The parietal cells of the stomach react to this by increasing the secretion of hydrochloric acid. Also, when exposed to gastrin, pepsin begins to be secreted in large quantities. These are one of the main enzymes in the stomach, which ensure the efficient process of digestion of food.

Along with this, stimulation of the release of bicarbonates and mucus is observed. These substances secreted by the gastric mucosa protect it from the negative effects of hydrochloric acid together with pepsin.

Also, the functions of the hormone include inhibition of the movement of food from the stomach further along the digestive tract. This is necessary so that hydrochloric acid and pepsin have enough time to digest food.

The secreting effect of gastrin is also the production of prostaglandin E, which occurs in the gastric mucosa. This provokes vasodilation, increased blood circulation. Under the action of prostaglandin, the gastric mucosa swells physiologically, and the movement of leukocytes is observed. These cells take part in the process of digestion. Leukocytes are able to secrete certain enzymes.

In the small intestine and pancreas there are also gastrin receptors that stimulate the release of certain hormonally active and pancreatic peptides and enzymes. These include secretin, somatostatin, cholecystokinin and others. This ensures the further process of digestion that takes place in the intestines.

What affects hormone secretion?

The stimulated effect on hormone secretion produces:

• vagus nerve and sympathetic system;
• release of insulin, histamine;
• the presence in human blood or directly in the stomach of protein breakdown products in the form of oligopeptides or free amino acids.

This action allows you to stimulate the digestion process when food enters the stomach, if a person sees it, smells it. The opposite inhibitory effect on the secretion of this hormone is produced by:

• high levels of hydrochloric acid;
• prostaglandin E;
• somatostatin;
• endogenous opioids;
• cholecystokinin, secretin.

Reasons for changing hormone levels

The normal concentration of this hormone in the blood is from 1 to 10 pmol / l. A change in the level of gastrin is observed with the development of the following diseases:

• chronic gastritis, which is accompanied by atrophic changes in the mucosa;
• peptic ulcer (12 duodenal ulcer, stomach);
• anemia, which is provoked by a deficiency of vitamin B12;
• Zollinger-Ellison syndrome, accompanied by the formation of a malignant tumor of the pancreas;
• oncology of the stomach;
• chronic nature of renal failure.

Diagnostics

In most cases, a gastrin test is indicated for suspected Zollinger-Ellison syndrome. In the presence of this disease the level of the hormone rises significantly, which provokes an increased release of hydrochloric acid. As a result, multiple ulcers form in the human stomach, intense abdominal pain, diarrhea with liquid contents, belching with a sour smell, and other symptoms are observed.

Also, a high level of the hormone, which is independent of food intake, can be observed with a stomach ulcer. The same disease that affects the duodenum is accompanied by slightly different indicators. The level of the hormone rises only after eating, and at other times is normal.

A low concentration of this substance may indicate problems with the thyroid gland. This negative process is observed in hyperthyroidism. Also low level hormone is observed after surgery to remove the pylorus and vagotomy as a result of crossing the vagus nerve.

The use of synthetic gastrin (instruction for use implies the name pentagastrin) is shown during some diagnostic procedures- to detect medullary thyroid carcinoma, when performing intragastric pH-metry or sounding. This drug increases the secretion of hydrochloric acid, the internal factor of Castle and pepsin.

This medication available in powder form. The solution prepared from it is injected subcutaneously.

Bibliography

1. Vinogradov A.V. Differential diagnosis of internal diseases. M.: MIA. 2001.
2. Diseases of the endocrine system: hands. on internal diseases/ ed. I. I. DEDOV. - M. : Medicine, 2000. - 568 p. : ill.
3. Glycosylated hemoglobin and free fatty acids in the diagnosis of diabetes and metabolic syndrome: New opportunities for diagnosis, therapy and risk assessment. – Moscow: [b. and.], 2014. - 100 p. : fig., tab. - Bibliography. at the end of chapters.
4. Clinical guidelines. Rheumatology. Ed. E.L. Nasonova- M.: GEOTARD-Media, 2006.

Instructions for medical use drug

Description of the pharmacological action

Neutralizes hyperacidity gastric juice. Due to the large contact surface, it has a high adsorption capacity.

Indications for use

Peptic ulcer of the stomach and duodenum, gastritis, dyspepsia, heartburn, digestive disorders medicinal origin(cytostatics, glucocorticosteroids, anti-tuberculosis drugs); diarrhea, food and other intoxications.

Release form

1 sachet with 16 g of oral gel contains colloidal aluminum phosphate 1.2 g and pectin 0.32 g; in cardboard box 20 pcs.

Pharmacodynamics

An antacid; has an adsorbing and enveloping effect. Neutralizing free HCl in the stomach (within 10 minutes it reduces acidity - pH to 3.5-5), reduces the activity of pepsin. The antacid effect is not accompanied by alkalization of gastric juice and secondary hypersecretion of HCl. Being adsorbed on the gastric mucosa in the form of hydrophilic colloidal micelles, it prevents the influence of aggressive factors on the gastric and duodenal mucosa, enhances their own defense mechanisms, does not change the physiology of digestion, and practically does not cause reactive secretion of HCl. Due to its adsorbing properties, it removes bacteria, viruses, gases, endo- and exotoxins from the gastrointestinal tract.

Pharmacokinetics

Acts quickly - after 10 minutes. Does not cause reactive hypersecretion of hydrochloric acid, violations of acid-base balance, does not affect the metabolism of phosphorus.

Contraindications for use

Not detected even with prolonged use.

Side effects

Nausea, vomiting, taste changes, constipation, allergic reactions. With long-term use in high doses- hypophosphatemia, hypocalcemia, hypercalciuria, osteomalacia, osteoporosis, hyperaluminemia, encephalopathy, nephrocalcinosis, impaired renal function. In patients with concomitant renal failure - thirst, decreased blood pressure, decreased reflexes.

Dosage and administration

Inside, you can pure form or before taking, dilute in half a glass of water, a single dose - 1-2 sachets of gel (in 1 sachet - 8.8 g of aluminum phosphate) 2-3 times a day; in case of poisoning, burns with caustic drugs - 3-5 sachets once. With ulcerative lesions of the gastrointestinal tract, reflux esophagitis, the drug is taken 2-3 hours after meals and at bedtime and immediately - if pain occurs; with gastroesophageal reflux and diaphragmatic hernia - immediately after meals and at night, with enterocolitis - before meals 2 times a day in the morning and evening, with colonopathy - before breakfast and at night; duration of treatment - 15-30 days. The maximum duration of treatment without consulting a doctor is 2 weeks. The drug is repeated if pain occurs in the intervals between doses. Children: up to 6 months - 4 g (1/4 sachet) or 1 teaspoon (4 g) after each of 6 feedings; after 6 months - 8 g (1/2 sachet) or 2 teaspoons after each of 4 feedings.

Overdose

Symptoms: constipation.

Treatment: laxative drugs. Chronic overdose (Newcastle bone disease) develops when using the drug for more than 2 weeks: hypophosphatemia (malaise, myasthenia gravis, osteomalacia, osteoporosis), development of renal failure (or its aggravation), aluminum encephalopathy (dysarthria, apraxia, convulsions, dementia).

Interactions with other drugs

Reduces and slows down the absorption of digoxin, indomethacin, salicylates, chlorpromazine, phenytoin, H2-histamine receptor blockers, beta-blockers, diflunisal, isoniazid, tetracycline antibiotics and quinolones (ciprofloxacin, norfloxacin, ofloxacin, enoxacin, grepofloxacin, etc.), azitro cefpodoxime, pivampicillin, rifampicin, indirect anticoagulants, barbiturates (should be used 1 hour before or 2 hours after taking an antacid), antihistamine drugs - fexofenadine, dipyridamole, zalcitabine, bile acids- chenodeoxycholic and ursodeoxycholic, penicillamine and lansoprazole. M-anticholinergics, slowing down the emptying of the stomach, enhance and lengthen the action.

Special instructions for admission

With long-term administration, adequate dietary intake of phosphates should be ensured. Long-term treatment is not recommended in case of an unspecified diagnosis. Does not contain sugar and can be used in patients diabetes. Maybe joint application with cimetidine, ketoprofen, disopyramide, prednisolone, amoxicillin. Does not affect the results of X-ray examination.

Storage conditions

In a dry place, at a temperature of 15–25 °C.

Best before date

Belonging to ATX-classification:

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Gastrin(from Greek. gaster- stomach) - a hormone produced by G-cells of the antrum of the stomach and, in a small amount, G-cells of the duodenum, as well as D-cells of the pancreas. The secretion of gastrin occurs in the blood.

Gastrin stimulates the secretion of hydrochloric acid by parietal cells, increases the secretion of pepsin by the main cells of the stomach, which, together with an increase in the acidity of gastric juice, providing an optimal pH for the action of pepsin, contributes to better digestion of food in the stomach.

At the same time, gastrin increases the secretion of bicarbonates and mucus in the gastric mucosa, thereby protecting the mucosa from the effects of hydrochloric acid and pepsin. Gastrin inhibits gastric emptying, which ensures sufficient duration of exposure of hydrochloric acid and pepsin to the food bolus for digestion.

Gastrin increases the secretion of secretin, cholecystokinin, somatostatin and a number of other hormones, as well as the secretion of small intestine and pancreatic enzymes, thus preparing the conditions for the intestinal phase of digestion.

In nature, there are three main, chemically homologous, forms of gastrin:

• gastrin-34 (the so-called "big gastrin") - a polypeptide of 34 amino acids
• gastrin-17 ("small gastrin"), consisting of 17 amino acids
• gastrin-14 ("minigastrin"), consisting of 14 amino acids.

Gastrin is found not only in endocrine cells, but also in nerve fibers, as well as in the gray matter of the cerebral cortex, in the neuro- and adenohypophysis (Pichugina I.M. and others).

Gastrinomas and Zollinger-Ellison syndrome

80% of gastrinomas are localized in the anatomical region known as the “gastrinoma triangle”, the boundaries of which are the confluence of the gallbladder and common bile ducts, the point between the middle and lower thirds of the duodenum and the projection of the junction of the head and body of the pancreas (see figure on the left). Gastrinomas have two main growth patterns:

• aggressive character (malignant course with a frequency of 25% of cases of all gastrinomas),
• non-aggressive character (conditionally benign course - 75%).

Abnormal secretion of gastrin in International classification ICD-10 diseases are classified in Class IV "Diseases of the endocrine system, eating disorders and metabolic disorders (E00-E90)", heading "E16.4 Abnormal secretion of gastrin. Hypergastrinemia. Zollinger-Ellison Syndrome".

Gastrin-17 and atrophic gastritis

Now the most promising screening method is considered to be the measurement of blood levels (however, this test is too expensive for mass screening of healthy individuals):

• gastrin-17 level
• pepsinogen level I
• ratio of pepsinogen I to pepsinogen II