Gastric acid secretion physiology

 

The mechanism by which parietal cells transport hydrogen ions against concentration gradient is not fully understood. It is believed that the ionization of water is the main source of the production of hydrogen ions (H+). When water becomes ionized, one molecule of H+ and H- when it is given external energy. External supply of energy may be in the form of ultraviolet light or as in living systems oxidative phosphorylative processes which is coupled with cytochrome system. The H+ ions produced from this unnatural process is actively secreted into the lumen of the gut. Chloride ions (C1-) on the other hand are actively transported from the interstitial fluid into the lumen. The H+ and C1- ions are secreted initially into the intracellular canaliculi before they are transported to the lumen. H+

                H20                    H+                    &                     0H+

May also be generated from other systems within the cell. For example, substitutes like glucose via the flavoprotein cytochrome respiratory enzyme chain. For each H+ secreted into the lumen, one molecule of 0H- is kept within the cell.

            Bicarbonates HC03 are extremely important in production of gastric acid by parietal cells. Carbonic anhydrase enzyme has been shown to be in abundance within the gastric lumen. Thus the gastric arterial circulation brings in carbondioxide (C02) which is extracted by parietal cells and with the addition of water under the influence of carbonic anhydrase leads to the secretion of carbonic acid in the parietal cell.

            H20                   +                      C02 = H2C03                Carbonic anhydrase

This carbonic acid (H2C03) then breaks down into HC03 and H+ ions.

            H2C03              HC03-   +          H+

The bicarbonate ion thus formed goes back into the circulation, so that the venous return from the stomach is usually alkaline and contains a high level of HC03- but with a reduced C02 concentration.

            H+ ion derived from the breakdown of H2C03 is coupled with the 0H- which is kept in the cell in order to neutralize the alkalinity of the cell which is caused by accumulation of 0H-.

            0H-                   +                      H+     =          H20

The process of Na+ and K+ exchange through the Na+ pump continues unabated. The energy for the active transport of hydrogen ions across parietal cell membrane comes from aerobic glyucolysis. Acid secretion is depressed by anaerobic conditions and inhibitors of oxidative phosphorylation like dinitropherol causes the reduction in acid elaboration.

Gastric acid analysis are performed by the following indications

 

To determine the ability of the patient to secret HCL as in achlorhydria

To determine the amount of acid secreted by the individual

To determine the type of surgery to be performed because in incomplete vagotomy for peptic ulcer, stromal ulcer may follow the ordinary procedure.

 

The following are performed in gastric acid analyses.

  • Basal acid output (BAO)

  • Histalog test (Augmented histamine test)

  • Saline load test

  • Diagnex blue test

  • Secretin for gastric analysis

  • Serum gastrin level

  • Hollander insulin test

  • Gastric analysis using secretin

 

Endocrine secretion

Paraneurons

APUD

 

Introduction
Cell Biology
Histology
Embryology
Gross Anatomy
Lymphatic drainage
Organ integration
Clinical anatomy

Quiz

Dissector
Physiology

Biochemistry

Chemical Pathology

Anatomical Pathology

Pharmacology

Imaging

Medicine

Surgery

    


Gastric acid physiology

 

 

 

 

 

 

 

 

Main Subject Course Links

Anatomy Anesthesia Biochemistry Chemical pathology Community Health
Dermatology ENT Gynecology Hematology Imaging
Medicine Medical microbiology Obstetrics Ophthalmology Pathology
Pediatrics Pharmacology Physiology Psychiatry    Surgery/Orthopedics
eLab eOSCE eProcedures eInvestigations eSchool/Videopage
eOrgans eLocator Anatomy Museum eDissector eFractures
All diseases eClerking eTreatment eDoctor ePatient

    


 


Electronic School of Medicine
Creator: Oluwole Ogunranti