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LETTERS TO THE EDITOR
HEPAT 01175
Assessment of mucosal defenses in portal hypertensive gastropathy Although gastric acidity is normal or reduced in patients with portal hypertensive gastropathy, the mucosa is particularly susceptible to the damaging activity of bile salts, ethanol and nonsteroidal antiinflammatory agents (l), which raises the question of the state of mucosal defenses in this condition. Fourteen patients of both sexes were studied, aged 48-69, with clinical and/or histological diagnosis of cirrhosis (Child's class A or B) and endoscopic signs of mild to moderate congestive gastropathy (mosaic-like pattern of diffuse erythema). Esophageal varices FI were present in 10 patients, none of whom had previous endoscopic sclerotherapy. A matched group of healthy controls was also studied. Fasting gastric juice was collected and neutral, acid and total mucoproteins were measured and the ratio of neutral to total mucoproteins x l00 (Mucoprotective Index (MI)) was calculated for a qualitative assessment of mucus secretion (2). H + concentrations and the volume of gastric juice were measured, and juice and plasma osmolality were determined. On the basis of the above parameters gastric bicarbonate secretion was calculated by Feldman's method (3). During endoscopy gastric mucosal blood flow was measured in both the gastric fundus and antrum with laser Doppler equipment (PF3, Perimed, Sweden). The amount of total mucoproteins in the gastric juice, the value of the MI and the output of gastric bicarbonate were all found to be significantly lower in patients with
hypertensive gastropathy than in normal subjects (p
LETTERS TO THE EDITOR
HEPAT 01175
Assessment of mucosal defenses in portal hypertensive gastropathy Although gastric acidity is normal or reduced in patients with portal hypertensive gastropathy, the mucosa is particularly susceptible to the damaging activity of bile salts, ethanol and nonsteroidal antiinflammatory agents (l), which raises the question of the state of mucosal defenses in this condition. Fourteen patients of both sexes were studied, aged 48-69, with clinical and/or histological diagnosis of cirrhosis (Child's class A or B) and endoscopic signs of mild to moderate congestive gastropathy (mosaic-like pattern of diffuse erythema). Esophageal varices FI were present in 10 patients, none of whom had previous endoscopic sclerotherapy. A matched group of healthy controls was also studied. Fasting gastric juice was collected and neutral, acid and total mucoproteins were measured and the ratio of neutral to total mucoproteins x l00 (Mucoprotective Index (MI)) was calculated for a qualitative assessment of mucus secretion (2). H + concentrations and the volume of gastric juice were measured, and juice and plasma osmolality were determined. On the basis of the above parameters gastric bicarbonate secretion was calculated by Feldman's method (3). During endoscopy gastric mucosal blood flow was measured in both the gastric fundus and antrum with laser Doppler equipment (PF3, Perimed, Sweden). The amount of total mucoproteins in the gastric juice, the value of the MI and the output of gastric bicarbonate were all found to be significantly lower in patients with
hypertensive gastropathy than in normal subjects (p
