Gastric analysis and semen analysis are laboratory tests to examine stomach secretions and semen, respectively. Gastric analysis indicates include investigating peptic ulcers or Zollinger-Ellison syndrome. Tests measure acid output and check for factors like intrinsic factor. Semen analysis is done for infertility issues and checks semen volume, pH, motility, morphology and sperm count. Both analyses require fasting or abstinence before sample collection via tube. Tests examine physical and microscopic properties of the samples.

1. Gastric analysis
Semen analysis
Dr. Salman Ansari(MBBS)
Dept. of Pathology
Kanachur Institute of Medical Sciences

2. Topics
● Gastric analysis
● Semen analysis

3. GASTRIC ANALYSIS

4. Gastric analysis
● Definition
● Indications and contraindications
● Sample collection
● Tests

5. Gastric juice
Gastric juice consists of:
● HCl(hydrochloric acid): makes pH acidic, kills many micro-
organisms and breaks down proteins
● Pepsin: partial digestion of proteins
● Mucus
● Intrinsic Factor(IF): needed for absorption of vitamin B12

6. Gastric analysis
- Lab tests to measure secretions of stomach and serum
gastrin

7. When to do gastric analysis?
Indications:
- To investigate recurrent peptic ulcer disease
- To detect Zollinger-Ellison syndrome
- To find out the cause of raised fasting serum
gastrin levels
- To differentiate between benign and malignant
ulcer

8. Zollinger-Ellison syndrome or Gastrinoma

9. When NOT to do gastric analysis?
Contraindications:
- Esophageal stricture/varices
- Recent history of severe gastric bleed
- Hypertension
- malignancy

10. Collection of sample
- Patient should be fasting overnight - no eating or
drinking after midnight
- Withhold any drugs which affect gastric acid
secretion(such as antacids, H2 blockers)
- Collected using oral or nasogastric tube

12. Physical Examination
● Volume:
Normal - 20-100 ml
Increased in: Zollinger-Ellison Syndrome, pyloric stenosis
● Colour:
Normally colourless, with faint pungent odour
Red : fresh blood
Brown, coffee-ground appearance: old blood

14. Coffee ground appearance

15. ● pH:
normal pH: 1.5-3.5
Increased to >7.0(alkaline): in pernicious anemia due to lack
of HCl

16. Tests
Tests for gastric acid secretions
Test for intrinsic factor
Cytological examination for
malignant cells
Test for gastrin

17. 1. Gastric acid secretion tests
3 things are measured:
BAO(Basal Acid output): amount of HCl
secreted without any stimulation
MAO(Maximum Acid output): amount secreted
after stimulation - patient injected with a drug to
stimulate gastric acid secretion - e.g:
pentagastrin(peptavlon), histalog(betazole)
PAO(Peak Acid Output)

18. For BAO:
- sample collected every 15 minutes for 1 hour - total of 4
samples
For MAO:
- patient given an injection of pentagastrin s.c/i.m and then
sample collected every 15 minutes for 1 hour - total of 4
samples
PAO:
- calculated from 2 consecutive samples showing the highest
acid secretion

20. Interpretation
High values seen in:
● Duodenal ulcer
● Zollinger-Ellison
syndrome(gastrinoma)
● Anastomotic ulcer
Low values(achlorhydria) in:
● Atrophic
gastritis(pernicious
anemia)
● Malignant ulcer of
stomach

21. 2. Test for intrinsic factor
● IF is needed for absorption of Vit. B12 from small intestine
● Schilling test: to detect pernicious anemia

22. 3. Tests for gastrin
Serum gastrin levels: by radioimmunoassay
High levels seen in: atrophic gastritis, ZE
syndrome
Gastrin provocation test
Done for diagnosing gastrinoma

23. 4. Cytological examination for malignant cells
● By brushing, lavage, aspirate or biopsy material through
endoscopy
● Smear is prepared and stained and examined for
malignant cells

24. SEMEN ANALYSIS

25. Semen analysis
● Definition
● Indications
● Sample collection
● Examination

26. Semen analysis
- Examination of semen(seminal fluid) for abnormalities
- Defect may be In number of sperms(quantitative)
In quality of sperms(qualitative)

27. When to perform?
Indications:
- Infertility
- Effectiveness of vasectomy
- Medicolegal purpose: in alleged sexual assault cases
- Examining semen of donors for artificial insemination
- Assisted reproductive techniques(in vitro fertilisation)(IVF)

28. Sample collection
- By masturbation
- Should avoid ejaculation for minimum of 2 days before
giving sample(and maximum of 7 days)
- Collected in plastic container

30. Tests
Physical examination
Microscopic examination
Immunologic examination
Biochemical examination

31. Physical examination
● Liquefaction:
semisolid coagulated at first - becomes completely liquid
by 30 minutes
● Viscosity:
fairly viscid - tested by dropping from pipette - falls drop by
drop normally

32. ● Appearance:
initially opaque, white grey - becomes gray after
liquefaction
● Volume: 1.4-1.7 ml
● pH: alkaline - 7.2-8.0

33. Microscopic examination
● Sperm aggregation or agglutination:
motile sperm stick to each other
● Cells other than sperms:
check for WBCs, epithelial cells
● Sperm motility:
normally 38 to 42% of sperms should be motile

34. ● Sperm vitality:
alive or dead - 55-63% live forms
● Sperm count:
normal is >20 million/ml
● Sperm morphology:
check for normal and abnormal forms - percentage of
normal sperms should be >30%

37. Immunologic analysis: antibodies against sperms - MAR
test(mixed antiglobulin reaction)
Biochemical analysis: fructose test

38. Gastric analysis - summary
- Definition
- Indications and contraindications
- Collection of sample
- Tests

39. Sperm analysis - summary
- Definition
- Indications
- Collection of sample
- Tests

40. References:
● Gastric Analysis - Prep manual for Undergraduates - Ramadas Nayak
● Semen Analysis - Essentials of Clinical Pathology - Shirish Kawthalkar
Questions:
salman.s.ansari92@gmail.com
For PPT, scan: