Clinical aspects of gastric protection
The stomach is constantly exposed to a variety of irritating and damaging factors, including its own acid-pepsin secretion, bile, spicy foods, micro-organisms, alcohol and drugs. In spite of this hostile environment, the gastric mucosa is usually capable of maintaining its integrity due to several protective mechanisms. Among the most frequently mentioned local mechanisms implicated in this protection are: (i) mucus/alkaline secretion that adheres to the surface of epithelium and exhibits a pH gradient within the unstirred water layer; (ii) the gastric mucosal barrier preventing the penetration of acid into the mucosa; (iii) rapid epithelial cell renewal allowing for a quick recovery from the mucosal insults; (iv) rich mucosal blood flow providing oxygen and necessary nutrients to increase cellular resistance; and (v) the presence of natural humoral factors, particularly certain prostaglandins (PGs), whose action may explain various aspects of mucosal protection.
KeywordsAspirin Acidity Prostaglandin Bismuth Hunt
Unable to display preview. Download preview PDF.
- GUTH, P.H. (1984). In Mechanisms of Mucosal Protection in the Upper Gastrointestinal Tract. Allen A. et al. (eds) pp. 253–257, New York: Raven Press.Google Scholar
- HINSDALE, J.G., ENGEL, J.J., WILSON, D.E. (1974). Prostaglandins, 6, 459–500.Google Scholar
- KARIM, S.M.M. & FUNG, W.P. (1976). Prostagl. Thromb. Res., 2, 529–538.Google Scholar
- KONTUREK, S.J., KWIECIEN, N., OBTULOWICZ, W., DEMBINSKA-KIEC, A. & OLEKSY, J. (1982). In Gut Peptides and Ulcer. Miyoshi, A. (ed.) pp. 429–433, Tokyo: Biomed. Res. Found.Google Scholar
- LE DUC, L.E. & NEEDLEMAN, P. (1979). J. Pharmac. exp. Ther., 211, 181–188.Google Scholar
- RACHMILEWITZ, D., BRANSKI, D., SHARON, P. & KARMELI, F. (1984). In Mechanisms of Mucosal Protection in the Upper Gastrointestinal Tract. Allen A. et al. (eds) pp. 329–333, New York: Raven Press.Google Scholar
- ROBERT, A. (1981). In Physiology of the Gastrointestinal Tract. Johnson, L.R. (ed) pp. 1407–1434, New York: Raven Press.Google Scholar
- ROBERT, A. (1984). In Mechanisms of Mucosal Protection in the Upper Gastrointestinal Tract. Allen et al. (eds) pp.377–382, New York: Raven Press.Google Scholar
- TARNAWSKI, A., STACHURA, J., IVEY, K.J., HOLLANDER, D., KRAUSE, W.J., MACH, T. & TERANO, A. (1982). Gastroenterology, 82, 1193.Google Scholar
- WRIGHT, J.P., YOUNG, G.O., KLAF, L.J., WEERS, L.A., PRICE, S.K. & MARKS, I.N. (1982). Gastroenterology, 80, 94–98.Google Scholar