Fibrinolysis in the Upper Gastrointestinal Tract

Local fibrinolytic activity can contribute towards the continuation of haemorrhage from many tissues. Fibrinolysis has been documented in the gastro-duodenal mucosa, gastric venous drainage and gastric secretions and a recent double blind trial indicates a beneficial effect of a fibrinolytic inhibitor in patients with gastrointestinal haemorrhage. In the present study, the fibrinolytic role of acid, pepsin, trypsin, chymotrypsin and other components of the gastro-duodenal and biliary secretions has been studied in control subjects and patients with a variety of diseases using a labelled clot lysis method. The effect of inhibitors and pH changes on the various systems has been assessed. In addition, the fibrin degradation products have been followed by acrylamide gel electrophoresis. In general, gastrointestinal fibrinolysis can be inhibited by pH changes or by various inhibitors and this may have therapeutic implications.