How does your stomach keep from digesting itself?

Gastric acid found in the stomach really isn’t that strong. Many articles on the internet (including this one) seem to give off the impression that gastric acid is powerful enough to end civilization as we know it.

Reflux esophagitis, referring to the injury with inflammation of the esophagus from gastric refluxate, is a common manifestation of GERD that is recognized during endoscopy [16]. However, in one study, most patients showed only mild or no erosion of the esophageal mucosa [47].

First, the stomach wall is covered by a thick coating of bicarbonate-rich mucus. This mucus forms a physical barrier, and its bicarbonate ions neutralize acid. Second, the epithelial cells of the stomach’s mucosa meet at tight junctions, which block gastric juice from penetrating the underlying tissue layers.

If you tend to experience indigestion symptoms at night, avoid eating for three to four hours before you go to bed. Going to bed with a full stomach means there is an increased risk that acid in your stomach will be forced up into your oesophagus while you are lying down. A little bit of acid reflux is normal and rarely cause any symptoms. It becomes GORD when large amounts of reflux occur, and the sensitive lining of your oesophagus may get inflamed by repeated irritation from stomach acid.

If you smoke, the chemicals you inhale in cigarette smoke may contribute to your indigestion. These chemicals can cause the ring of muscle that separates your oesophagus from your stomach to relax, causing acid reflux. Being overweight puts more pressure on your stomach, making it easier for stomach acid to be pushed back up into your gullet (oesophagus). This is known as acid reflux, and is one of the most common causes of indigestion.

protective barrier between cells and stomach acid

Nonprotein sulphydryls in the epithelium are capable of binding reactive free radicals. Rapid cell turn-over and the process of restitution contribute to an intact epithelial lining. In subepithelial protection, mucosal blood flow is essential in supplying the epithelium with nutrients and oxygen and for disposal of hydrogen ions and noxious agents permeating the mucosa. Prostaglandins may maintain blood flow and prevent vascular endothelial injury caused by ethanol. Several agents have been established as protective for the gastric mucosa.

  • The mucus made by the epithelial cells also forms a barrier on the walls of the stomach.
  • Studies that attempt to associate tooth erosion with the findings from esophageal pH-metry often only assess gastric reflux occurring classically 5 cm above the LES.
  • Acid is secreted by the parietal cells of the gastric mucosa, which is under the influence of several biologic agents or activities (eg, histamine, gastrin, vagal nerve stimulation).
  • GERD is usually caused by a transient relaxation of the LES and less commonly by a transient increase in intra-abdominal pressure or a low resting pressure of the LES [34].

Despite these problems, stomach acid is very important. You need it in order to properly digest the food you eat.

J. Gastroenterol. 36, 467-473 (2001).

Dentists may be the first persons to diagnose the possibility of GERD in these “silent refluxers,” particularly when observing unexplained instances of tooth erosion, which might be accompanied by coexisting hyposalivation. Numerous laboratory, and mainly case-control and observational clinical studies in adults and children, have shown a clear though variable relationship between GERD and tooth erosion. However, further randomized clinical trials are required to demonstrate that the progression of dental erosion reduces or ceases following gastric acid suppression therapy in patients with confirmed GERD.

The gastric mucosa is continuously exposed to many noxious factors and substances. How the gastric mucosa maintains structural integrity and resists auto-digestion by substances such as acid and pepsin puzzled clinicians and investigators for more than 200 years. The gastric epithelium must also resist damage from extrinsic agents, including Helicobacter pylori (H. pylori) and noxious ingestions such as ethanol and nonsteroidal anti-inflammatory drugs (NSAIDs). The luminal surface of the stomach is covered by a viscoelastic mucus gel layer that acts as a protective barrier against the harsh luminal environment. The structural characteristics of this barrier are primary indicators of its physiological function and changes of its composition have been identified in gastrointestinal pathologies.

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April 28, 2010

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