GASTRO PANEL

Pepsinogen is an inactive precursor of the enzyme pepsin, which is activated by hydrochloric acid in gastric juice to the active enzyme pepsin.

Pepsin is the main enzyme needed to break down the proteins in the food that enters the stomach. There are two types of Pepsinogens that are part of the serological examination of the gastric mucosa and their determination can direct which part of the stomach is affected.

• Pepsinogen I (PG I) is secreted by specialized cells in the body of the stomach and is therefore a specific marker of mucosal damage in this compartment. Its low levels indicate the presence of atrophic gastritis, and the degree of decrease correlates with the severity of the disease. Atrophic gastritis develops slowly, often asymptomatically, and as the disease progresses a large proportion of hydrochloric acid-producing cells die, as do those secreting pepsinogen. This leads to impaired absorption of Vitamin B12 and other trace elements, which is associated with the development of pernicious anaemia. On the other hand, atrophic gastritis is the most significant risk factor for the development of gastric adenocarcinoma. Its symptoms are uncharacteristic, often missed or neglected, and when pain, vomiting, gastric bleeding and ascites occur, the process is already at a fairly advanced stage. Pepsinogen I analysis is a convenient means of assessing and monitoring the condition of the gastric mucosa.
• Pepsinogen II (PG II) – its secretion is carried out by cells located in the cardiac and pyloric departments of the stomach, as well as by Brunner’s glands in the duodenum. Pepsinogen II is elevated in all diseases associated with infection of H. pylori. Depending on the severity of the inflammatory reaction, the H. pylori gastritis may present with damage predominantly to the antral portion of the stomach, the body of the stomach, or pangastritis. Hydrochloric acid and pepsinogen II levels are persistently elevated, which is used for the diagnosis of this type of hyperacid gastritis. Decreases in Pepsinogen II levels over the course of treatment are indicative of the effectiveness of therapy and can be used in monitoring treatment and assessing recovery of the gastric mucosa.
• Pepsinogen I/Pepsinogen II ratio – the Pepsinogen I/Pepsinogen II ratio is used together with the Pepsinogen I value for early diagnosis of atrophy of the gastric mucosa (atrophic gastritis). In this case, the ratio decreases below 3.
• Gastrin – this is a hormone that is secreted by another type of cells that are part of the diffuse endocrine system of the gastrointestinal tract. They are found in the lining of the stomach, duodenum and pancreas. Stimulants for gastrin secretion are a decrease in the acidity of gastric juice, consumption of protein food, stretching of the stomach walls. The reason for high levels of Gastrin can also be Zöllinger-Ellison syndrome – a gastrin-producing tumor that can be located both within the confines of the gastrointestinal tract (pancreas, stomach, duodenum) and outside it (ovaries, omentum). The gastro package also includes serological diagnosis of Helicobacter pylori infection, which is the most common cause of inflammation of the gastric mucosa.

Preparation before the study-

Recommends that the patient discontinue any treatment 7-10 days prior to sample collection. Pepsinogens respond more slowly and PGI and PGII levels may remain above the cutoff values for up to 2-3 weeks. Abrupt cessation of long-term treatment is usually followed by acid hypersecretion, often accompanied by symptoms of hyperacidity and extremely low levels of Gastrin. Other important conditions before performing the test are that it should be done on an empty stomach, at least 12 hours after the last food intake. Alcohol and fatty food should be avoided 24 hours before the test, caffeinated beverages should not be consumed 8 hours in advance, and smoking should be discontinued 30 minutes before sampling for this test.

Gastro panel analysis :