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Gastric Juice Composition
Gastric juice, produced by the stomach, contains hydrochloric acid to kill microbes and solubilize food, pepsinogen for protein digestion, gastric lipase for fat digestion, and intrinsic factor for vitamin B12 absorption.
Regulation of Acid Secretion
Acid secretion in the stomach is regulated by acetylcholine, gastrin, and histamine binding to specific receptors, leading to increased proton pump activity and acid release into the stomach lumen.
Mechanism of Acid Production
Acid production involves a proton pump system that pumps protons out of the cell, bicarbonate secretion to neutralize acid, and various hormonal and neural pathways to control acid secretion levels.
Mucosal Protection
The stomach mucosa is protected by mucus layers that trap bicarbonate secretions, neutralize acid, and prevent erosion of the stomach lining, stimulated by short reflexes, the enteric nervous system, and prostaglandins.
Vagus nerve and secretin
Stimulate mucus production in the stomach for protection against acid.
Gastric ulcers and peptic ulcers
Result from failed protection or excessive acid production, leading to erosion of the stomach lining.
H
Gram-negative bacteria causing inflammation of the stomach lining and associated with gastric ulcers.
Proton pump inhibitors
Drugs that block acid production by inhibiting the proton pump, used to treat ulcers.
Histamine receptor antagonists
Drugs that reduce stomach acid by blocking histamine receptors, such as cimetidine and Zantac.
Potassium leak channels
Potential target for developing new anti-ulcer drugs by blocking these channels to reduce acid production.
Prostaglandins
Protective mechanism in the stomach that can be interfered with by nonsteroidal anti-inflammatory drugs, leading to ulcers.
Somatostatin
Hormone that reduces acid secretion in the stomach, impaired by H. Pylori infection, leading to increased acid production and ulcers.
Proton Pump Inhibitor (PPI)
Binds irreversibly to the proton pump, leading to a long-lasting effect.
Enteric Coated Form
Given to protect the drug in the stomach and ensure it gets absorbed in the small intestine.
Second Generation PPIs
Improved versions of PPIs, with Nexium (S form) being one example.
H
Involves a combination of antibiotics, proton pump inhibitors, and bismuth compounds.
Antibiotic Resistance
Development is a concern when using antibiotics for a long period, leading to the need for combination therapies.
Bismuth Compound
Slows acidification of the bacterial interior, enhancing antibiotic action when combined with PPIs.
Potassium Competitive Acid Blockers
Potential new class of drugs that may outperform PPIs in reducing acid secretion and enhancing antibiotic action.
Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)
Cyclooxygenase inhibitors that can lead to ulcers by reducing the protective layer of mucus in the stomach.
Misoprostol
Synthetic prostaglandin that can be given alongside NSAIDs to counteract their side effects.
Regulation of Gastric Acid Secretion
Controlled by gastrin, histamine, and acetylcholine, leading to the development of effective ulcer treatments.