| Exocrine gastric secretion and gastritis: pathophysiological and clinical relationships. | |
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MedLine Citation:
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PMID: 21448537 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Gastric exocrine secretion, both acid and non-acid, is required for micronutrients absorption, such as iron, calcium and vitamin B12, drugs absorption, protein digestion. Clinical presentation of a gastric secretion impairment might be then characterized by the presence of both gastrointestinal and non-gastrointestinal specific symptoms (i.e. anemia) or to a non-response to therapies. The main factor that impairs gastric exocrine secretion homeostasis is mucosal chronic inflammation that principally occurs after colonization by Helicobacter pylori (Hp). The extent and distribution of gastritis ultimately determine the clinical outcome linked to differences in gastric acid secretion status, the involvement of gastric body leading to a decrease in gastric exocrine secretion with possible progression to mucosal atrophy towards cancer. A correct clinical strategy in the management of Hp infected patients should be then to early identify body involvement, a diagnosis generally missed in that body biopsies are not routinely performed. The use of gastric serological markers, gastrin and pepsinogens, are helpful in suspecting the presence of mucosal atrophy but their diagnostic accuracy for non-atrophic chronic gastritis topography is not adequate despite a good specificity due to the low sensitivity, of all the available biomarkers. Gastric serology associated to anemia/iron-deficiency screening might nevertheless been helpful in the framing of patients that undergo endoscopy in order to highlight the need of extensive mucosal biopsies sampling. |
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Authors:
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E Colacci; A Pasquali; C Severi |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: La Clinica terapeutica Volume: 162 ISSN: 1972-6007 ISO Abbreviation: Clin Ter Publication Date: 2011 |
Date Detail:
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Created Date: 2011-03-30 Completed Date: 2011-08-09 Revised Date: 2012-02-27 |
Medline Journal Info:
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Nlm Unique ID: 0372604 Medline TA: Clin Ter Country: Italy |
Other Details:
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Languages: eng Pagination: e19-25 Citation Subset: IM |
Affiliation:
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Gastroenterology Unit, Department of Internal Medicine and Medical specialties, University Sapienza, Rome, Italy. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Absorption Anemia / etiology Biological Markers Biopsy Gastric Acid / secretion* Gastrins / blood Gastritis / classification, diagnosis, physiopathology* Gastritis, Atrophic / blood, diagnosis, pathology, physiopathology Helicobacter Infections / physiopathology Helicobacter pylori Humans Intrinsic Factor / secretion Micronutrients / pharmacokinetics Models, Biological Parietal Cells, Gastric / secretion* Pepsinogens / blood, secretion Secretory Rate Stomach / innervation, pathology |
| Chemical | |
Reg. No./Substance:
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0/Biological Markers; 0/Gastrins; 0/Micronutrients; 0/Pepsinogens; 9008-12-2/Intrinsic Factor |
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