Gastric physiology

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The progressive and recent spectacular advances in gastric physiology have been welcomed by gastroenterologists and surgeons. Most important has been the benefit to patients with epigastric pain, secretory or motility disturbances of the stomach, or a variety of unpleasant sequelae that have followed alteration of normal function. In this review gastric secretion, motility, gastric emptying, and the practical applications of each are discussed.

Because digestion but little absorption takes place in the stomach, the gastric epithelium is suitably arranged to facilitate this. Deep crypts with multiple mucosal glands provide luminal access for the many components of gastric secretion.

There are three anatomical glandular areas of the stomach: cardiac, oxyntic, and pyloric. The cardiac glands occupy a small portion of the upper stomach below the esophagus. The secretions are mucoid and there is a turnover of cells within 48 hours after injury. The pyloric or antral glandular area occupies 10% to 20% of the stomach where mucus, gastrin, and pepsinogens are produced.1 The oxyntic glands occupy 80% to 90% of the glandular mucosa. At least six types of cells have been identified in this area and secretions include mucus, pepsinogens, hydrochloric acid, intrinsic factor, histamine, and serotonin. Most research has been directed toward the parietal cell and chief cell, the source of acid and pepsin.

Methods of study

Classic methods of studying gastric physiology have been indirect; an intact animal model was used to derive data. A reliable method has been to position a tube in the stomach under fluoroscopy and . . .



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