Gastric Acid Backdiffusion and Neural Alarm System
The pathophysiological concept that gastroduodenal ulcer is caused by aggressive factors including acid, pepsin, and Helicobacter pylori is met by the current medical treatment involving proton pump inhibitors and antibiotics. Since the time when prostaglandins were discovered to be protective factors, with their deficiency being responsible for the mucosal lesions caused by nonsteroidal anti-inflammatory drugs, attention has also been paid to the defensive forces of the gastroduodenal mucosa. However, the possibility that nociceptive neurons participate in gastric mucosal protection from injury was not thought of until recently. This article summarizes the experimental evidence for afferent neurons being a neural emergency system (Holzer 1998) that alarms protective mechanisms in the stomach in the face of pending acid injury. There is good reason to postulate that a malfunction of this alarm system is an etiological factor in certain forms of gastroduodenal ulcer disease.
KeywordsAspirin Histamine Bicarbonate Prostaglandin Luminal
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