Predictive Value of Individual Gastric Secretion Indices and Their Constellations for Predicting the Response of Gastric Mucosal Parietal Cells to Pentagastrin Stimulation and Famotidine Blocking Effect in Patients with Gastric and Duodenal Ulcers

Introduction. Evaluating acid-reducing medications through their effect on various gastric juice parameters in peptic ulcer patients provides deeper insight into the complex mechanism of gastric secretion, which includes acidity levels, pepsin, electrolytes, bicarbonates, and mucus. The aim of the study. To determine the prognostic value of gastric secretion parameters and their constellations for predicting parietal cell response to submaximal pentagastrin stimulation and the blocking effect of famotidine in patients with gastric and duodenal peptic ulcer disease. Materials and methods. The study included 40 randomized Helicobacter pylori-positive patients (28 women, 12 men, aged 18-68) with endoscopically confirmed duodenal ulcer disease in the acute phase. Modified fractional probing was used to assess changes in gastric secretion. Results. H+ debit in basal secretion showed a significant direct correlation with multiple parameters. Different acid responses to stimulation were associated with specific baseline parameter constellations. Weak response to H2-blocker was confirmed in patients with hyperacidity after stimulation, combined with elevated HCl and increased total acidity in basal secretion. A strong response to H2-blocker was confirmed in several parameter constellations, with the best predictive constellation (p < 0.01) including elevated N-acetylneuraminic acid, normal K+, normal pepsin debit, normal pepsin, and elevated Na+ in basal secretion. Conclusions. The prognostic value of gastric secretion parameters and their constellations allows tailoring blocker dosage: higher doses for patients predicted to have a weak response and lower doses for those predicted to have a strong response to stimulation.