Dffect of propranolol on insulin-induced gastric acid secretion. Improvement of the discriminative value of the Hollander test
Fournet, J.; Hostein, J.; Fouque, B.; Serre, F.; Gavend, M.; Bonnet-Eymard, J.
Gastroenterologie Clinique et Biologique 1(12): 995-1006
1977
ISSN/ISBN: 0399-8320 PMID: 606625 Document Number: 111670
Gastric acid secretion and serum gastrin were studied during insulin hypoglycemia in 25 duodenal ulcers and 30 vagotomized patients (26 truncal and 4 selective vagotomies). All these patients underwent 2 insulin tests, 1 of which was carried out after propranolol, 20 mg orally; this drug induced a significant reduction (P < 0.05) of acid concentration and secreted volumes in duodenal ulcers and vagotomized patients; during hypoglycemia, the gastrin level rose simultaneously with the plasma epinephrine level. Propranolol reduced the gastrin response in duodenal ulcer patients but this change was not statistically significant; it completely abolished this response in vagotomized patients. These findings confirm the intervention of epinephrine in the gastric secretory response to hypoglycemia. In 24 vagotomized patients without recurrence of ulceration 3 yr after operation, 8 out of 11 Hollander positive tests were converted into negative ones by propranolol. Secretory changes induced by .beta. adrenergic blockade during insulin hypoglycemia permit more valid estimation of the degree of interruption of nervous fibers after vagotomy, though they were not compared to any other criteria which could attest that the operation was a success.