Acid Related Diseases

This is divided into 7 sections: the production of acid in the stomach, the regulation of gastric acid secretion, the pharmacology of acid secretion, the biology of acid-related diseases, gastric and duodenal ulcer disease, gastro esophageal reflux disease, and Helicobacter pylori. Each of these sections is extremely well written and provides historical insights into the various areas. For example, the first section point out that Paracelsus was one of the first to relate chemistry to disease; however, he was under the mistaken assumption that acid found in the stomach was ingested.

Section 2 presents an accounting of William Beaumont’s study of the gastric fistula in Alexis Saint Martin, which was the result of a gunshot wound. Also included in this section is the accounting of Pavlov’s delineation of vagal function in relation to the GI tract. Other important milestones of gastric physiology that are recounted include Codes’ study of the relationship of histamine to gastric secretion and the work of Bayle’s and Starling in identifying the hormone secretin.

In Section 2, gastric acid secretion and its neural and endocrine regulation is covered in a comprehensive manner as are all aspects of parietal cell function.

The history of the therapeutic approach to acid-related diseases is detailed in Section 3 and includes the Sippy diet, antacids, sulfated polysaccharide (sulcralfate), histamine H2 receptor antagonists, and proton pump inhibitors along with surgery.

Section 4 deals with the barrier function of the upper GI tract, intragastric pH, pepsin, intrinsic factor, and regulation of the growth of gastric epithelium.

The final section deals with Helicobacter pylori and covers its well-known history and the consequences of gastric colonization along, with the pathogenesis and treatment options.

  • Duodenal ulcers
  • PPI therapy for bleeding ulcers
  • Stress related mucosal disease

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