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Basal Nocturnal Acid Output Gastric Analysis

Norm of Basal Nocturnal Acid Output Gastric Analysis

Basal Acid Output (BAO)
SI Units

Adult Female

Normal

1–4 mEq/hour

1–4 mmol/hour
Duodenal ulcer 3–8 mEq/hour 3–8 mmol/hour
Gastric carcinoma 0–3 mEq/hour 0–3 mmol/hour
Gastric ulcer 1–3 mEq/hour 1–3 mmol/hour
Atrophic gastritis 0 mEq/hour 0 mmol/hour
Pernicious anemia 0 mEq/hour 0 mmol/hour
Zollinger-Ellison syndrome >20 mEq/hour >20 mmol/hour

Adult Male

Normal 2–5 mEq/hour 2–5 mmol/hour
Duodenal ulcer 5–10 mEq/hour 5–10 mmol/hour
Gastric carcinoma 0–3 mEq/hour 0–3 mmol/hour
Gastric ulcer 1–5 mEq/hour 1–5 mmol/hour
Atrophic gastritis 0 mEq/hour 0 mmol/hour
Pernicious anemia 0 mEq/hour 0 mmol/hour
Zollinger-Ellison syndrome >20 mEq/hour >20 mmol/hour

 

Usage of Basal Nocturnal Acid Output Gastric Analysis

Aids diagnosis of pernicious anemia, duodenal or stomal ulcer, Ménétrier's disease, and Zollinger-Ellison syndrome.
Increased of Basal Nocturnal Acid Output Gastric Analysis
Duodenal ulcer, gastric ulcers in some cases, peptic ulcer disease, pyloric ulcer, and Zollinger-Ellison syndrome. Drugs include adrenergic blockers, alseroxylon, caffeine, calcium salts, cholinergics, corticosteroids, deserpidine, ethyl alcohol (ethanol), rauwolfia, rescinnamine, and reserpine.
Decreased of Basal Nocturnal Acid Output Gastric Analysis
Achlorhydria, anemia (pernicious), gastric atrophy, gastric neoplasm, gastric ulcer, and gastritis. Drugs include antacids, anticholinergics, beta-blocking agents, cimetidine, famotidine, nizatidine, ranitidine hydrochloride, and tricyclic antidepressants.

 

Description of Basal Nocturnal Acid Output Gastric Analysis

Basal nocturnal acid output is the rate of secretion of acid by the stomach when the client is calm and resting, after a 12-hour fast, and at least 24 hours after the last dose of medications that increase or decrease gastric acid. It is measured in millimoles of titratable acidity per hour.

 

Professional Considerations of Basal Nocturnal Acid Output Gastric Analysis

Consent form NOT required.

Risks
Complications of nasogastric tube insertion include bleeding, dysrhythmias, esophageal perforation, laryngospasm, and decreased mean pO2.
Contraindications
In clients with esophageal varices, evaluate risk versus benefit in severely thrombocytopenic clients at risk for hemorrhage.

 

Preparation

  1. See Client and Family Teaching.
  2. Obtain a Levin tube, a lubricant, four clean plastic containers without preservative, a Toomey syringe, suction equipment, and a marker or grease pencil.
  3. Prepare the suction apparatus and tubing.

 

Procedure

  1. Position the client sitting or lying on the left side.
  2. Insert a Levin tube with a radiopaque tip through the client's nose or mouth into the stomach. Position the tube tip in the lumen below the stomach fundus and confirm the placement by radiography or fluoroscopy.
  3. Reposition to a sitting position. Wait at least 10 minutes before proceeding further.
  4. Apply low, continuous suction to the Levin tube. At 15 and 30 minutes, withdraw two specimens with a Toomey syringe and discard the aspirate.
  5. Begin continuous aspiration of gastric contents using the syringe, for a total of 60 minutes. Collect the aspirate into the collection containers (labeled 1, 2, 3, 4), using a new collection container every 15 minutes until basal acid output collection is complete.

 

Postprocedure Care

  1. Send all four sequentially labeled containers to the laboratory.
  2. The specimens should be refrigerated if not tested within 4 hours.
  3. Remove the nasogastric tube.
  4. Resume previous diet.

 

Client and Family Teaching

  1. Fast for 12 hours, and do not chew gum or smoke cigarettes during the 6 hours before the test.
  2. The test takes about 2 hours. Bring reading material or other diversions.
  3. The test involves the insertion of a tube through the nose into the stomach and removal, with a syringe, of the gastric contents through the tube. The insertion may be uncomfortable and may cause a pressurelike feeling or cause you to gag and cough. You will be asked to take sips of water and swallow to make the tube insertion easier. Removal of the stomach contents causes no pain.

 

Factors That Affect Results

  1. Reject specimens if contaminated with bile.
  2. Stimuli that may increase gastric acid production include smoking, the sight or odor of food, or stimuli that cause anger, fear, or depression.
  3. The amount of gastric acid increases as body weight increases.

 

Other Data

  1. This test is sometimes followed by stimulation of gastric acid production with pentagastrin or histamine. See also Gastric acid analysis test; Gastric acid stimulation test.