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Gastrointestinal diseases and pregnancy
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
Murtaza Arif, Anjana Sathyamurthy, Jessica Winn, Jamal A. Ibdah
Proton pump inhibitors: Proton pump inhibitors (PPIs) including lansoprazole, rabeprazole, pantoprazole, and esomeprazole are classified as FDA pregnancy category B drugs. Omeprazole is the only PPI, which is classified as FDA pregnancy category C because of dose-related embryonic and fetal mortality observed in animal studies. PPIs act as inhibitors of parietal cell H+/K+ ATPase (the proton pump responsible for hydrogen ion secretion) and are the most effective inhibitors of gastric acid secretion. These are the drugs of choice in nonpregnant patients for treatment of severe erosive reflux esophagitis and can heal esophageal lesions that are refractory to treatment with H2RAs. However, PPIs have not been extensively used in pregnancy and limited safety data are available for their use during pregnancy. A recent meta-analysis showed no significant increase in the risk of congenital anomalies in pregnant women exposed to various PPIs (22). PPIs should be used only in pregnant women with refractory symptoms who are not responding to H2RAs. Lansoprazole may be the preferred PPI because of its lack of teratogenicity in animal studies and limited safety reports during pregnancy.
The patient with acute gastrointestinal problems
Published in Peate Ian, Dutton Helen, Acute Nursing Care, 2020
Rebecca Maindonald, Adrian Jugdoyal
The secretory actions of the parietal cells keep the stomach contents acidic (pH 1.5–2.0) which prevents the growth of harmful bacteria, initiates the digestion of proteins and facilitates the digestion of plant and meat tissue.
StomachGastric Secretions, Motility, Digestion and Vomiting
Published in Peter Kam, Ian Power, Michael J. Cousins, Philip J. Siddal, Principles of Physiology for the Anaesthetist, 2020
Peter Kam, Ian Power, Michael J. Cousins, Philip J. Siddal
Specific receptors for histamine, acetylcholine and gastrin located in the basolateral membrane of the parietal cell stimulate acid secretion. However, somatostatin, epidermal growth factor, β-adrenergic agonists and enteroglucagon inhibit acid secretion, presumably by an indirect mechanism as specific receptors for these factors have not yet been identified. Histamine binds to H2 receptors at the basolateral membrane of the parietal cell to stimulate acid secretion. The parietal cells also contain a muscarinic receptor, which increases acid secretion when vagal stimulation releases acetylcholine. Some species possess gastrin receptors in the gastric parietal cells, but in humans, gastrin receptors may be absent. However, gastrin is a potent stimulant of acid secretion in humans, and its effects appear to be mediated by the release of histamine from other cells in the gastric glands binding to H2 receptors in the parietal cell to stimulate acid production.
Probiotics for the Treatment of Gastric Diseases
Published in Nutrition and Cancer, 2022
Yingying Xing, Xinyue Gu, Guojing Ruan, Simiao Chen
Probiotics and their metabolites have certain antioxidant activities; therefore, they have certain application prospects in alleviating oxidative stress in the stomach. Gastric acid and pepsin self-digestion are some of the reasons for the formation of gastric ulcers. High levels of reactive oxygen species (ROS) can also mediate gastric mucosal damage. Currently, the commonly used treatment methods for gastric ulcers primarily include H2 receptor blockers, antacids, PPI, and antibacterial agents against H. pylori infection. The mechanism involves controlling the secretion of gastric acid by blocking H2 receptors or blocking the hydrogen potassium (H+/K+) ATPase pump in gastric parietal cells (33). Studies have suggested that animals treated with probiotic fermented milk significantly reduce the levels of •O2-, H2O2, ONOO-/•OH-, thereby improving the body’s ROS/NO balance (34). Butyric acid produced by probiotics also inhibits the production of oxidation products (18) and can also restrain NF-κB pathway activation to eliminate ROS and repair oxidatively damaged cells (27). As a result, it is believed that probiotics and their metabolites may reduce the oxidative damage to macromolecules in the stomach by reducing the generation of ROS and alleviating oxidative stress in the stomach to treat gastric diseases.
Anti-ulcerogenic effect of methanol fraction of Ocimum gratissimum leaves extract and honey on indomethacin-induced gastric ulcer in rats
Published in Egyptian Journal of Basic and Applied Sciences, 2021
Aanuoluwa James Salemcity, Blessing Oluwagbamila Omolaso, Oghenefega Sheila Ogegere, Victoria Olasumbo Oluokun
The disease could be associated with mucosal damage caused by hyper-secretion of acid from the parietal cell of the intestinal tracts as well as environment-induced, lifestyle, diet and stress – either physiological or physical. Other causal factors of peptic ulcer are H. pylori, cigarettes, alcohol consumption, the use of non-steroidal anti-inflammatory drugs (NSAIDs) and Zollinger–Ellison syndrome [3]. However, only few people exposed to the major causative agents develop ulcer, partly because of predisposition or proneness as a result of genetic or environmental factors. Genetic polymorphisms in various inflammatory cytokine genes are related to peptic ulcer. For instance, IL-1β polymorphisms could influence the mucosal synthesis of the cytokine, which could play role in pathogenesis of H. pylori-induced gastro-duodenal ulceration [4]. An understanding of these events might be of utmost relevance in designing new antiulcer drugs.
Ultra-structural study of the indomethacin-induced apoptosis and autophagy in rat gastric parietal cells
Published in Ultrastructural Pathology, 2020
Sahar M Gebril, Yuko Ito, Eman E. Abu-Dief, Mahmoud Rezk Abdelwahed Hussein, Hoda M Elsayed, Asmaa Naser Mohammad, Usama M Abdelaal, Kazuhide Higuchi
Parietal cells (PCs) are the most predominant cell type in the gastric mucosa. They are responsible for acid secretion, and they are frequent in the isthmus and the neck of the gastric glands.9,10 Ultra-structurally, PCs have unique characteristics such as microvilli lacking the glycocalyx coat, intracellular canaliculi (ICC), numerous large mitochondria and limited protein synthetic apparatus, the rough endoplasmic reticulum (RER), and the Golgi bodies.11 The secretory activity of PCs alternates according to the physiological phases of feeding or fasting.12During fasting the PCs undergo membrane recruitment of ICC membrane into the cytoplasm with the formation of tubulovesicles (tbv) that will be ready to be added to the membrane on activation.13,14 During feeding, PCs have wide ICC with highly folded membrane studded with H +. K+ -ATPase subunits (proton pumps) for active acid formation.15,16