Acid Production and Stimulation Changes with GERD, PUD, and Gastric Disorders
The pathophysiology of gastric acid stimulation and production is a complex process . The parietal cells play a critical role in this process. These cells are in the stomach walls. The cells produce gastric juice or hydrochloric acid, which fights germs in addition to playing a role in the digestive process by balancing the stomach pH for the pepsin enzyme. The acids that leave the cells find their way into the gastric lumen through the mucous layer ( University of Maryland Medical Center. (n.d.). The gastric acid secretion stimulation comes as a result of numerous factors. Gastrin and paracrine pathways such as histamine and ghrelin and, for instance, are hormones that help in stimulating secretion of the gastric acid (University of Maryland Medical Center. (n.d.). The neurotransmitter called acetylcholine is also another gastric acid stimulator in addition to eating and different chemicals such as protein, coffee, and ethanol.
However, the processes of stimulation of the gastric juice production by the parietal cells and the secretion of the same juice sometimes face a lot of changes with the presence of gastrointestinal disorders. Gastroesophageal reflux disease (GERD), is an example of a condition that may cause such alterations (Marcus & Anand, 2016). The GERD causes acid reflux or heartburn, which is a situation where there is a backup of gastric contents into the esophagus instead of entering the lumen (Marcus & Anand, 2016). The backup is a potential danger to the esophagus, pharynx, and the respiratory tract, mostly when it occurs continuously. In such a case, a patient suffering from the GERD have challenges with swallowing and regurgitation may be likely (Marcus & Anand, 2016). There is an increase in gastric acid stimulation and production because the defection in the lower esophagus increases the volume of gastric acid that refluxes into the esophagus (Sachs et al., 2014) .
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Peptic ulcer disease (PUD) is another condition that alters the process. Through agents such as Helicobacter pylori ( H. pylori), the condition can lead to excessive secretion of acid and transferable ulcer etiology. Abdominal discomfort, and nausea and epigastric pain are the presentations of the disease(Sachs, Shin, Munson, & Scott, 2014) . Lastly, gastritis disorders such as ulcer gastritis due to Helicobacter pylori also cause inflammation on the stomach lining, thus prevent it from producing enzymes and acid (Sachs et al., 2014) .
Gender as a Factor in the Pathophysiology of GERD, PUD, and Gastritis
The GERD symptoms are more severe in women than men, although the clinical importance of these differences is unclear, some researchers suggest that health-seeking behaviors are the major distinctive factor University of Maryland Medical Center. (n.d.). Also, Pregnancy will increase the incidence of heartburn, and this can also explain why GERD is common in females than males. On the other side, factors such as age play a critical role in the severity of PUD. However, gender plays a minimal role in the PUD as a disease. As for gastritis, Chronic H. affects more males than females, according to Marcus & Anand (2016).
Diagnosis and Treatment for GERD, PUD, and Gastritis in Gender
Checking the presenting symptoms is the primary diagnosis of GERD. For instance, PH monitoring to determine the acid level in the esophagus can be of help ( Huether&McCance, 2017). Endoscopy for esophagus inflammation and Manometry, which is a study that measures the function of the lower esophageal valve, can be of help for GERD diagnosis ( Huether & McCance, 2017). For the treatment of GERD, a combination of lifestyle change and antiacids drugs are critical. Physicians can diagnose gastritis with blood tests, stool tests, and upper endoscopy. Huether & McCance (2017) argue that for PUD, endoscopy with biopsy, stool monoclonal tests, and urea breath tests are critical. In all three cases, antacid drugs are essential for treatment.
References
Huether, S. E., &McCance, K. L. (2017). Understanding pathophysiology (6th ed.). St. Louis, MO: Mosby.
Marcus, A. J., & Anand, B. (2016). Chronic Gastritis: An overview. Retrieved from emedicine.medscape.com/article/176156-overview#a6
Mayo Clinic. (n.d.). Peptic ulcer . Retrieved from http://www.mayoclinic.org/diseases-conditions/peptic-ulcer/home/ovc-20231363
Sachs, G., Shin, J. M., Munson, K., & Scott, D. R. (2014). Gastric acid-dependent diseases: a twentieth-century revolution. Digestive disorders and sciences , 59 (7), 1358-1369.
University of Maryland Medical Center. (n.d.). Gastritis . Retrieved from http://www.umm.edu/health/medical/altmed/condition/gastritis
