Gastric Acid Secretion and Gut Hormone Release in Patients with Crohn's Disease

Thirty patients with Crohn's disease who were admitted to our department for surgical treatment were examined regarding gastric acid secretion stimulated by tetragastrin and release of gut hormones such as gastrin, GIP, and total-GLI after test meal loading. The mean MAO of these patients was significantly increased before the operation. MAO and PAO correlated with the length of the small intestinal lesions and the resected segment of the small intestine. Widespread lesions and resection of 100 or more centimeters of the small intestine were associated with increased acid output. Patients with Crohn's disease showed lower gastrin, GIP, and total-GLI levels in the fasting and postprandial state than the control. Immunohistochemical study with anti-glycentin antibody revealed a loss of positive cells in severe lesions of the ileum resected from Crohn's patients for surgical therapy. These results indicate that careful attention to gastric hypersecretion is necessary for the patients with Crohn's disease who have widespread lesions of the small intestine before and after surgery. We speculate that decrease of enterogastrone such as enteroglucagon may cause gastric acid hypersecretion in Crohn's patients.