Mechanisms of stress-related mucosal damage.
During the last 15 years, there has been a dramatic decline in the incidence of bleeding from stress-related mucosal damage. This decrease probably relates to an increased understanding of those mechanisms responsible for the pathogenesis of stress-related mucosal damage and the application of this knowledge to prophylaxis and treatment. Stress-related bleeding has become less of a clinical problem, in part, because of the development of improved techniques for the treatment of shock and its accompanying gastric mucosal hypoperfusion. The nearly routine use of prophylactic antacid and/or histamine (H2)-receptor antagonist therapy to adequately buffer intragastric acidity is another factor that has minimized the development of stress-related damage. As continued understanding of the mechanisms responsible for stress damage is obtained and therapy applied appropriately, this disease should become a disorder of only historical interest in years to come.
Miller
T A
TA
Department of Surgery, University of Texas Medical School, Houston 77030.
D005744:Gastric Acid / Q000378:metabolism; D005753:Gastric Mucosa / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D012307:Risk Factors; D013312:Stress, Physiological / Q000473:pathology* / Q000503:physiopathology