title: Functional anatomy and physiology of gastric secretion.
abstract: OBJECTIVE
  This review summarizes the past year's literature regarding the neuroendocrine and intracellular regulation of gastric acid secretion, discussing both basic and clinical aspects.
  
  
  RESULTS
  Gastric acid facilitates the digestion of protein as well as the absorption of iron, calcium, vitamin B12, and certain medications. High acidity kills ingested microorganisms and limits bacterial overgrowth, enteric infection, and possibly spontaneous bacterial peritonitis. The main stimulants of acid secretion are gastrin, released from antral gastrin cells; histamine, released from oxyntic enterochromaffin-like cells; and acetylcholine, released from antral and oxyntic intramural neurons. Ghrelin and coffee also stimulate acid secretion whereas somatostatin, cholecystokinin, glucagon-like peptide-1, and atrial natriuretic peptide inhibit acid secretion. Although 95% of parietal cells are contained within the oxyntic mucosa (fundus and body), 50% of human antral glands contain parietal cells. Proton pump inhibitors are considered well tolerated drugs, but concerns have been raised regarding dysbiosis, atrophic gastritis, hypergastrinemia, hypomagnesemia, and enteritis/colitis.
  
  
  CONCLUSIONS
  Our understanding of the functional anatomy and physiology of gastric secretion continues to advance. Such knowledge is crucial for improved management of acid-peptic disorders, prevention and management of neoplasia, and the development of novel medications.
authors.affiliation: aDivision of Gastroenterology, Department of Medicine, Virginia Commonwealth University Health System bHunter Holmes McGuire Veterans Affairs Medical Center, Richmond, Virginia, USA.
authors.forename: Mitchell L
authors.initials: ML
authors.lastname: Schubert
mesh_terms: D005744:Gastric Acid / Q000378:metabolism*; D005755:Gastrins / Q000502:physiology; D017506:H(+)-K(+)-Exchanging ATPase / Q000502:physiology; D006632:Histamine / Q000502:physiology; D006801:Humans; D009490:Neurosecretory Systems / Q000033:anatomy & histology / Q000473:pathology / Q000502:physiology; D054328:Proton Pump Inhibitors / Q000009:adverse effects; D015398:Signal Transduction / Q000502:physiology
chemical_list: D005755:Gastrins; D054328:Proton Pump Inhibitors; D006632:Histamine; D017506:H(+)-K(+)-Exchanging ATPase