Effect of toal parenteral nutrition on gastric acid secretion

While total parenteral nutrition is widely used, its effects on gastrointestinal function are not well understood. We measured acid secretion in 11 patients during total parenteral nutrition. Five of these patients were retested at least one month after resuming oral intake. Total parenteral nutrition significantly stimulated acid secretion compared to saline infusion (5.5 +/- 2.0 vs 1.8 +/- 0.6 mEq H+/hr, P less than 0.001) (mean +/- SEM), especially in those patients who are hypersecretors. There was no difference in pentagastrin-stimulated maximal acid output during TPN or saline infusion. Basal and pentagastrin-stimulated acid secretion were similar during and after a course of total parenteral nutrition, suggesting that gastric atrophy did not occur during total parenteral nutrition therapy.