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Decrease gallbladder contraction
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Increase bicarbonate
Increase gallbladder contraction
Increase hydrochloric acid
Increase smooth muscle relaxation
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This patient is undergoing a secretin stimulation test in order to assess his pancreatic function. Secretin stimulates the pancreas to release bicarbonate. Secretin is a hormone released by duodenal S cells. Its release is stimulated by the presence of gastric acid or fatty acids in the duodenum. Secretin triggers biliary and pancreatic bicarbonate release as well and decreases gastric acid secretion through gastrin inhibition. The net effect is a more neutral environment (pH 6 to 8) that is more optimal for pancreatic amylase and lipase function. With the secretin stimulation test, duodenal contents are analyzed over a period of time following secretin administration. Its purpose is the assessment of pancreatic function, which is affected in cystic fibrosis, cancer, chronic pancreatitis, etc. Incorrect Answers: Answer 1: Decreasing gallbladder contraction is an effect of somatostatin. Released by D (GI mucosa cells) and delta cells (pancreas endocrine cells), somatostatin has an overall inhibitory effect on GI function, leading to decreased gastric, pancreatic, gallbladder, and small intestinal fluid secretion. Gastric acid triggers somatostatin release while vagal stimulation decreases its release. Answer 3: Increasing gallbladder contraction is an effect of cholecystokinin. Released by I cells (located in duodenum and jejunum), cholecystokinin slows gastric emptying while increasing pancreatic and gallbladder activity. Amino acids, peptides, and fatty acids stimulate its release. Answer 4: Increasing hydrochloric acid is an effect of gastrin. Released from G cells (gastric antrum), gastrin also increases gastric motility and promotes the growth of gastric mucosa. It is increased with distension, amino acids/peptides, and vagal stimulation. Gastrin levels are decreased by sufficiently low stomach pH (<1.5) and somatostatin. Answer 5: Increasing smooth muscle relaxation is an effect of vasoactive intestinal polypeptide (VIP). Released from GI parasympathetic ganglia, VIP also leads to increased intestinal fluid secretion and relaxation of sphincters. It is increased through vagal stimulation and GI distention and decreased by adrenergic stimulation. Bullet Summary: Secretin is released by duodenal S cells in the pancreas and leads to bicarbonate release.
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