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8 - Digestive physiology and gastric aspiration

from Section 2 - Pathophysiology

Published online by Cambridge University Press:  17 August 2009

By
P. Marko ,
A. Gabrielli ,
L.J. Caruso  and
A.J. Layon
Edited by
Adrian O. Alvarez
Edited in association with
Jay B. Brodsky ,
Martin A. Alpert  and
George S. M. Cowan
P. Marko
Affiliation:
Department of Anaesthesia, Intensive Care Unit, Taranaki Base Hospital, New Plymouth, New Zealand
A. Gabrielli
Affiliation:
Associate Professor of Anesthesiology and Surgery, University of Florida College of Medicine, Gainesville, FL, USA
L.J. Caruso
Affiliation:
Associate Professor of Anesthesiology and Surgery, University of Florida College of Medicine, Gainesville, FL, USA
A.J. Layon
Affiliation:
Professor of Anesthesiology, Surgery, and Medicine, University of Florida College of Medicine, Gainesville, FL, USA
Adrian O. Alvarez
Affiliation:
IMETCO, Buenos Aires
Jay B. Brodsky
Affiliation:
Stanford University School of Medicine, California
Martin A. Alpert
Affiliation:
University of Missouri School of Medicine, Columbia
George S. M. Cowan
Affiliation:
Obesity Wellness Center, University of Tennessee
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Summary

Physiology of gastric acid production

Introduction

The stomach secretes hydrochloric acid, intrinsic factor, bicarbonate, and mucus into its lumen. Functionally the stomach is divided into two parts: proximal and distal. The proximal part comprises the anatomic corpus and fundus. The distal portion is the antrum or pyloric gland region.

The cells responsible for gastric secretions are mucosal cells that line the surface of the gastric wall. The major secretory cells in the proximal part of stomach are parietal (oxyntic) cells, which secrete acid and intrinsic factor, and the chief (or peptic) cells, which secrete group I pepsinogen. In the distal portion of the stomach, pyloric glands secrete the hormones gastrin and somatostatin. Throughout the stomach, mucus neck cells secrete mucus and group II pepsinogen, and surface epithelial cells secrete bicarbonate, mucus, and group II pepsinogen.

Gastric acid secretion varies according to the time of the day, the time and types of food intake, psychological states, and other metabolic activities of the body. The cephalic phase of gastric secretion regulation is activated by thoughts of food, by sight, smell, and taste of food, and by the acts of chewing and swallowing. The vagus nerve is the major stimulatory pathway via M1 muscarinic cholinergic receptors.

Type
Chapter
Information
Morbid Obesity
Peri-Operative Management
 , pp. 89 - 110
Publisher: Cambridge University Press
Print publication year: 2004

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  • Digestive physiology and gastric aspiration
    • By P. Marko, Department of Anaesthesia, Intensive Care Unit, Taranaki Base Hospital, New Plymouth, New Zealand, A. Gabrielli, Associate Professor of Anesthesiology and Surgery, University of Florida College of Medicine, Gainesville, FL, USA, L.J. Caruso, Associate Professor of Anesthesiology and Surgery, University of Florida College of Medicine, Gainesville, FL, USA, A.J. Layon, Professor of Anesthesiology, Surgery, and Medicine, University of Florida College of Medicine, Gainesville, FL, USA
  • Edited by Adrian O. Alvarez
  • Edited in association with Jay B. Brodsky, Stanford University School of Medicine, California, Martin A. Alpert, George S. M. Cowan
  • Book: Morbid Obesity
  • Online publication: 17 August 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544477.011
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  • Digestive physiology and gastric aspiration
    • By P. Marko, Department of Anaesthesia, Intensive Care Unit, Taranaki Base Hospital, New Plymouth, New Zealand, A. Gabrielli, Associate Professor of Anesthesiology and Surgery, University of Florida College of Medicine, Gainesville, FL, USA, L.J. Caruso, Associate Professor of Anesthesiology and Surgery, University of Florida College of Medicine, Gainesville, FL, USA, A.J. Layon, Professor of Anesthesiology, Surgery, and Medicine, University of Florida College of Medicine, Gainesville, FL, USA
  • Edited by Adrian O. Alvarez
  • Edited in association with Jay B. Brodsky, Stanford University School of Medicine, California, Martin A. Alpert, George S. M. Cowan
  • Book: Morbid Obesity
  • Online publication: 17 August 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544477.011
Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Digestive physiology and gastric aspiration
    • By P. Marko, Department of Anaesthesia, Intensive Care Unit, Taranaki Base Hospital, New Plymouth, New Zealand, A. Gabrielli, Associate Professor of Anesthesiology and Surgery, University of Florida College of Medicine, Gainesville, FL, USA, L.J. Caruso, Associate Professor of Anesthesiology and Surgery, University of Florida College of Medicine, Gainesville, FL, USA, A.J. Layon, Professor of Anesthesiology, Surgery, and Medicine, University of Florida College of Medicine, Gainesville, FL, USA
  • Edited by Adrian O. Alvarez
  • Edited in association with Jay B. Brodsky, Stanford University School of Medicine, California, Martin A. Alpert, George S. M. Cowan
  • Book: Morbid Obesity
  • Online publication: 17 August 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544477.011
Available formats
×