PHYSIOLOGY OF GASTRIC SECRETION

Each day, about 2500 ml of gastric juice is secreted by our stomach. The gastric juice contains a variety of substances such as cations like Na+, K+ and H+ and anions like Cl- and others. Other than that, pepsins, lipase, mucus and intrinsic factor also contain in the gastric juice. Pepsin secreted by chief cell is responsible for the protein digestion while lipase which is also secreted by chief cell is responsible for the fat digestion. Apart from that, mucus line the mucosa layer to protect them from the acidity of hydrochloric acid. Intrinsic factor is the glycoprotein that essential in absorption on vitamin B12. The hydrochloric acid kills many ingested bacteria, provides the necessary pH for pepsin to start protein digestion, and stimulate the flow of bile. The hydrochloric acid is secreted by the parietal cell. Now, we discuss how the hydrochloric acid is secreted. The enzyme carbonic anhydrase, which is plentiful in parietal cells catalyzes the formation of carbonic acid (H2CO3) from water (H2O) and carbon dioxide (CO2). Then, carbonic acid dissociate into H+ and bicarbonate ion (HCO3-). H+ then will be transport to the lumen of the canaliculi from the cytoplasm through H+K+-ATPase in the membrane of parietal cell while potassium ion (K+) also is bring into the the cell. At the same time, Cl- and K+ diffuse out into the lumen through Cl- and K+ channels. In the canaliculi, H+ and Cl- will form the hydrochloric acid (HCl) and then secreted into the lumen. As mention before, the dissociation of carbonic acid also produce bicarbonate ion. This bicarbonate ion builds up in the cytosol and finally exits the parietal cell in exchange for Cl- via antiportes. The bicarbonate ion helps in buffering the hydrochloric acid near the mucous so that the hydrochloric acid will not penetrate the mucous and damage the mucosa layer. The gastric secretion has three phases which are cephalic phase, gastric phase and intestinal phase. During cephalic phase, the taste or smell of food, tactile sensation of food, or even thought

of food stimulate the medulla oblongata. Then, parasympathetic action potentials are carried by vagus nerves to the stomach. . Preganglionic parasympathetic vagus nerve fibers stimulate postganglionic neurons in the enteri plexus of the stomach. Postganglionic neurons stimulate secretion by parietal and chief cells and stimulate gastrin secretion by endocrine cells. Gastrin is carried through the circulation back to the stomach, where it stimulates secretion by parietal and chief cells. Next, during the gastric secretion, the food will enter the stomach and distend the stomach. Distention of the stomach activates parasympathetic reflex. Action potentials are carried by the vagus nerves to the medulla oblongata. The medulla oblongata then stimulates stomach secretions. Distention of the stomach also activates local reflexes that increase stomach secretions. The last phase is the intestinal phase. During this phase, the chyme which contain digestion products will enter the duodenum. Chyme in the duodenum with a pH less than 2 or containing fat digestion products (lipids) will inhibits gastric secretions by three mechanisms. Firstly, sensory vagal action potentials to the medulla oblongata inhibit motor action potentials from the medulla oblongata. Thus, it will inhibit the gastric secretion. Secondly, local reflex is set up to inhibit the gastric secretion. Thirdly, secretin, gastric inhibitory polypeptide and cholecystokinin is secreted by duodenum and enter the bloodstream. These hormone then are bring back to the stomach where they will inhibit the gastric secretion.