Heartburn is a burning pain or unpleasant feeling in the chest behind the breastbone. It is caused by stomach acid travelling up to the oesophagus. Usually, heartburn occurs after abundant eating and after eating foods that irritate the stomach (coffee, alcohol, acidic juices). Lying down, bending over, lifting things and tight clothes make heartburn worse.
Recurring heartburns are most commonly caused by reflux disease. In reflux disease, stomach contents rise up into the oesophagus more readily if the lower oesophageal sphincter functions poorly. The condition can cause oesophagitis and Barrett's oesophagus, in which the lower part of the oesophagus becomes similar to the mucous membrane of the stomach. If untreated, there is a risk of oesophageal cancer.
LOUNA’s heartburn assay includes several tests investigating the condition of the stomach.
Gastrin-17 is a hormone secreted exclusively from G-cells of the antrum and duodenum. Gastrin-17 is mainly secreted into the bloodstream by proteins in food. Gastrin-17 has an effect on the release of histamine into the bloodstream, which in turn stimulates the secretion of hydrochloric acid. The concentration of gastrin-17 in the blood decreases with increased acidity of stomach contents or antrum mucosal atrophy. Therefore, the hormone is a good indicator of the structure and function of the gastric antrum. Gastrin levels decrease with age.
Testing pepsinogens also helps visualise the situation. Pepsinogens I and II are precursors of the enzyme pepsin. They are broken down into pepsin by acid in the stomach. Pepsinogen I is released by chief cells in the fundus of the stomach. Pepsinogen II is secreted throughout the stomach and proximal duodenum. Some of the pepsinogens are secreted into the bloodstream. The more a helicobacter infection or autoimmune disease has damaged the fundus of the stomach, the lower the concentration of pepsinogen I or the ratio of pepsinogen I to II.
Helicobacter pylori lives on the surface of the stomach lining. The bacterium has developed means of surviving in the acidic environment of the stomach. Helicobacter pylori is usually contracted in childhood, often from person to person, but the exact route of transmission is unknown. Helicobacter can result in gastritis and lead to the development of a peptic ulcer.
When should the heartburn test be measured?
- Burning sensation behind the breastbone
- Stomach contents rise up to the throat/mouth
- Burning sensation in the stomach
- Pain in the upper abdomen
What does a heartburn test measure?
The test gives a view into the condition of the stomach, and it can investigate the causes of stomach symptoms. It is a good idea to consider the test if you suffer the symptoms below or suspect a disease mentioned below.
- Symptoms in the upper abdomen
- Atrophy of the gastric mucosa of the stomach (atrophic gastritis), causes a disorder in the absorption of vitamin B12, among other things.
- Helicobacter underlying peptic ulcer
- Risks relating to the volume of secretion of gastric acid
What should I know before sampling?
The sample can be collected at any time of the day. Before sampling, you should not eat, drink or smoke for 4–10 hours.
You may take your regular medication as usual, except for the following medicinal products that have impacts on the secretion of gastric fluids. However, you should first consult a doctor regarding the safe cessation of current medication. If, for any reason, the use of the medicines affecting gastric secretion cannot be suspended, this should be mentioned in connection with the sampling.
One week before sampling:
Hydrochloric acid secretion inhibitors:
- Ranitidine (for example, RANISAN, RANITIDIN, RANIXAL, ZANTAC)
- Famotidine (for example, PEPCID)
Proton pump inhibitors:
- Esomeprazole (for example, ESOMEPRAZOL, NEXIUM)
- Lansoprazole (for example, GASTERIX, LANSOPRAZOL ACTAVIS, ZOLT)
- Omeprazole (for example, LOSEC, OMEPRAZOL ACTAVIS, OMESTAD)
- Pantoprazole (for example, PANTOPRAZOL ACTAVIS, PANZOR, SOMAC CONTROL)
- Rabeprazole (for example, PARIET)
One day before sampling:
- Antacids (for example, GALIEVE MINT, GAVISCON, MAGNESIAMAITO, RENNIE)
- Cytoprotective agents (for example, ANTEPSIN)
How to interpret the GastPan result?
- P -Pepsin1: 30-160 µg/l (normal)
- P -Pepsin2: 3-15 µg/l (normal)
- P –PG1/PG2: 3-20 (normal)
- P –HepyAbG:<30 EIU (normal)
- fP –Gastr17: 1-7 pmol/l (normal)
An automatic comment on interpretation is issued with the result.
Please contact your physician or other healthcare professional if you suspect an illness or need help interpreting the results.
Read more about defining reference values.
What can cause elevated levels in GastPan?
Elevated gastrin concentrations are present in the following conditions:
- Vitamin B12 deficiency (pernicious anaemia)
- Chronic gastritis, or inflammation of the stomach lining
- Atrophic gastritis, or atrophy of the stomach lining
- Vagotomy, surgical operation to cut the nerves regulating the secretion of gastric acid
- Peptic ulcer
- Kidney failure
- Hyperthyroidism (overactive thyroid)
- Gastrinoma, or a tumour in the duodenum
- When using antacids (medications that neutralise gastric acid)
Elevated pepsinogen II concentration is a sign of inflammation of the gastric lining. Positive, in other words elevated, Helicobacter pylori antibodies indicate that the bacteria are active in the body. The antibodies remain elevated for a long time after treatment.
What can cause decreased GastPan values?
Decreased pepsinogen concentrations are present in the following conditions:
- Atrophic gastritis, or atrophy of the stomach lining
If the ratio of pepsinogen I to II decreases, it can suggest atrophy of the stomach lining. In this case, there is no or very little acid in the stomach.
Translation is not available
Fasting is required
Paastoa vaativissa tutkimuksissa tulee olla syömättä ja juomatta 10–12 tuntia ennen verikoetta. Tarvittaessa tuona aikana voi juoda lasin vettä.
Paastoverikokeet suosittelemme otettavaksi kello 8–10 välisenä aikana. Lue muista suosituksista täältä.
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