Stomach cells and what they produce. The main cells of the stomach glands produce

Date: 03.03.2020

Inflammatory diseases of the stomach can have different etiology and symptoms. Usually the cause of gastritis is bacterial damage to the tissues of the stomach against the background of irritation of the mucous membrane, but doctors identify other sources of the disease.

A separate cause of the onset of the disease can be considered the throwing of bile and pancreatic juice from the small intestine into the stomach, which leads to organ damage. Diet for reflux gastritis is a complementary treatment.

What is gastritis?

In the mucous membrane of the stomach there are special glands that produce acidic gastric juice and other substances necessary for digestion.

Pepsin is one of the enzymes in gastric juice. Pepsin breaks down protein while stomach acid breaks down food substrates and protects the body from infection.

The hydrochloric acid in the stomach is strong enough to harm organ tissues directly. The cells of the stomach secrete special substances that protect the stomach from the aggressive environment of its own contents. Chronic gastritis is characterized by inflammation of the stomach tissue.

Bacteria, alcohol consumption, certain medications, chronic stress, and poor diet can trigger the disease. When inflammation occurs, the mucous membrane changes and loses its protective cells.

Sometimes this process is accompanied by a feeling of early satiety - when a person feels a full stomach after eating a small portion of food. As gastritis develops over a long period of time, organ tissues gradually wear out and lose their protective properties.

It can cause cellular metamorphosis, metaplasia and dysplasia. Such changes are a precancerous condition characterized by a high risk of malignancy. Gastritis can be acute or chronic:

Acute gastritis begins suddenly and does not last long.
Chronic gastritis lasts a long time. If this form of gastritis is left untreated, the disease can last for years or even a lifetime.
Gastritis can be erosive or non-erosive:
Erosive gastritis. This type of gastritis can damage the stomach, causing erosion - tiny tears and ulcers in the lining of the stomach.
Non-erosive gastritis causes inflammation in the stomach lining without ulceration or damage to the lining.
Gastritis is also divided into types depending on the cause.

Causes of gastritis

The most common causes of gastritis include the following:

Infection with the bacterium Helicobacter pylori.
Damage to the stomach walls leading to reactive gastritis.
Autoimmune organ damage.

Helicobacter pylori infection is the most common cause of gastritis. The vital activity of this bacterium leads to damage to functionally important cells of the organ. In this case, gastritis is usually characterized by a non-erosive form of inflammation. The bacterium can cause both acute and chronic gastritis.

Infectious gastritis is especially common in developing countries. Infection often begins in childhood and is asymptomatic for a long time. Many people infected with H. pylori never complain of gastrointestinal upset. The onset of anxiety usually appears with age, when the organ is already sufficiently damaged.

Modern science does not have accurate data on how the infection spreads, although there is evidence that food, water and utensils can transfer bacteria from person to person. The bacterium is also found in the saliva of some patients suffering from infectious gastritis.

Reflux gastritis is a separate etiological form of the disease, somewhat similar to gastroesophageal reflux disease. The pyloric sphincter separates the stomach from the duodenum.

Isolation is needed to prevent the alkaline contents of the small intestine from entering the stomach. The walls of the stomach are not protected from the environment of intestinal juice, therefore, with reflux reflux, damage to the organ is possible. Reflux gastritis can occur due to a malfunction of the sphincter.

Reflux gastritis symptoms

Reflux gastritis differs from other forms of the disease in more pronounced symptoms.

In some patients, the disease is accompanied by pain and discomfort in the upper abdomen, in the epigastric region.

In addition, pain can appear on an empty stomach - this phenomenon is called "hunger pains". The asymptomatic course of reflux gastritis also occurs. Other possible symptoms:

Stitching pain in the abdomen.
Dyspeptic disorders.
Flatulence.
Nausea.
Vomit.
Frequent belching.
Loss of appetite.
Weight loss.
Heartburn.

Symptoms of reflux gastritis can be similar to those of a duodenal ulcer.

Possible complications of the disease

The following complications of reflux gastritis can occur with late treatment:
The onset of peptic ulcers.

These ulcers occur in the mucous membrane of the stomach or duodenum. Taking non-steroidal anti-inflammatory drugs and infection with Helicobacter increases the likelihood of ulcers.

Atrophic gastritis. This form of gastritis occurs when chronic inflammation of the stomach walls causes the destruction of functionally important glands. Reflux gastritis and chronic gastritis of a different etiology often turn into atrophic gastritis.

Anemia. Erosive gastritis often causes chronic bleeding in the stomach. Prolonged persistent blood loss leads to anemia. Anemia is a condition in which there is a deficiency of red blood cells, which affects the transport of oxygen in the blood.

Red blood cells contain hemoglobin, which is rich in iron and protein. Research shows that H. pylori gastritis and autoimmune atrophic gastritis can interfere with the body's ability to absorb iron from food, which can also cause anemia.

Vitamin B12 deficiency and pernicious anemia. Patients with autoimmune atrophic gastritis do not have enough special intrinsic factor to help absorb vitamin B12 in the stomach.

The body needs this vitamin to make red blood cells and nerve cells. Insufficient absorption of vitamin B12 can lead to a separate type of anemia called pernicious anemia.

Hyperplasia of stomach cells. Chronic gastritis increases the risk of developing benign and malignant stomach tumors. Chronic infectious gastritis can lead to the development of stomach lymphoma - cancer of the lymphoid tissue of the organ.

In addition to the above, it must be borne in mind that the acute form of gastritis can cause dangerous bleeding.

A thematic video will tell you about the symptoms of gastritis:

Diet for reflux gastritis

Diet is one of the forms of treatment and prevention of gastritis, since recovery directly depends on the functioning of the organ.

The main task is to reduce the load on the stomach and the use of "non-aggressive" food. The stomach should not secrete too much or too little acid. In addition, the diet should not contain spicy and fried foods that cause damage to the stomach wall.

What foods can you eat?

There are certain foods that should be consumed to relieve the symptoms of gastritis and stomach ulcers.

These foods can soothe tissues and reduce signs of inflammation. Below is a list of recommended foods specifically for the reflux gastritis diet.

Broccoli sprouts contain a beneficial chemical called sulforaphane. This substance helps to destroy the Helicobacter body due to its antibacterial properties.

A 2009 study published in the journal Cancer Prevention Research found that a group of patients who ate broccoli sprouts every day for two months had less significant signs of stomach inflammation.

Yogurt is an excellent choice for a gastritis diet. The product restores intestinal flora and improves the balance of the stomach environment. It is best to consume yoghurt, which contains beneficial bacterial cultures and a small amount of milk fat. Honey can be added to regular yogurt to improve anti-inflammatory properties.

Fruits help relieve reflux gastritis. Apples, bananas, pears, peaches, grapes, melon and kiwi are especially beneficial. Many vegetables are recommended for gastritis. These include broccoli, potatoes, and tomatoes. Fruit juices, skim milk, and curd cheese are also helpful.

What foods to exclude from the diet for reflux gastritis?

The following foods should be excluded:

Coffee.
Alcohol.
Black and green tea.
Spicy foods including chili and curry.
Black and red peppers.
Fatty foods.
Onion and garlic.
Oranges, grapefruit, figs, berries and dried fruits.
Fried food.
Butter.
Soft drinks or drinks with added sugar.
Carbonated drinks.
Citrus and pineapple juice.

This is not a complete list of foods, as some substances can cause individual reactions.

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Drug treatment and nutrition for antacid gastritis

The foods that are considered the most delicious for us tend to be the most harmful. The consumption of such food provokes the development of diseases, primarily the gastrointestinal tract suffers. In the modern world, the increase in the incidence of gastritis is growing, people of any age are susceptible to it. Antacid gastritis is considered one of the most difficult forms of this ailment.

A distinctive feature of this type of disease is a violation of the process of secretion of hydrochloric acid in the stomach.

1 Features of the disease
2 Manifestation of the disease
3 Diagnosing the disease
4 Treatment of the disease
- 4.1 Special diet
5 Consequences of the disease

Features of the disease

Antacid gastritis is a rare type of gastritis that requires certain rules to be followed. The disease is accompanied by the cessation of the secretion of hydrochloric acid, due to which the digestion of food in the stomach is disrupted, and in the case of a severe course of the disease, this process becomes completely impossible. Doctors identify the main reasons that provoke the appearance of the disease:

Genetic predisposition. Some scientists argue that the disease occurs due to genetic disorders.
Immune system disorder. For reasons unknown to date, the body begins to produce antibodies, destroying the cells of the stomach.
Alcohol and smoking destroy the parietal cells, which are responsible for the secretion of hydrochloric acid.
Helicobacter pylori.
Eating spicy, hot, rough food, as well as overeating, snacks, long breaks between meals.
Infections.
Stress.
The use of certain medications.

Manifestation of the disease

Signs of antacid gastritis have their own distinctive features. The most common symptoms of the disease should be highlighted:

a feeling of discomfort, heaviness and fullness in the stomach. This condition usually occurs after eating;
pains can be aching, sharp, dull;
belching, which is accompanied by an unpleasant putrid odor;
nausea and vomiting, in which there are impurities of bile;
odor from the mouth, reminiscent of the smell of rotten food;
constipation or diarrhea;
plaque on the tongue of white and gray;
lack of appetite;
aversion to certain foods;
flatulence, bloating;
fatigue, lethargy, drowsiness. This is due to nutritional deficiencies;
dry skin, pale face.

Any of the above conditions is a reason to visit a doctor in the near future in order to undergo a full diagnosis in order to exclude or confirm the disease. Only timely detection of the disease will allow you to get rid of it without consequences.

Diagnosing the disease

It is not enough to voice the symptoms, before prescribing therapy, the specialist must be sure whether the patient's experiences are associated with gastritis. For this, the patient can be assigned a special diagnosis:

mucosal biopsy, FGS;
general and biochemical blood test;
puncture of the spinal cord, due to which the anemia accompanying the disease is detected;
intragastric pH-metry. For the procedure, a special umbrella is used to measure the acidity of gastric juice;
bacteriological and X-ray examination.

Even with the course of treatment, the patient must additionally undergo an examination to determine the degree of progress, regression of the inflammatory process on the mucous membrane.

Treatment of the disease

Only a comprehensive treatment, which implies, in addition to the use of drugs, special nutrition, will get rid of antacid gastritis. Doctors usually prescribe the following drugs:

enzymatic drugs to normalize the digestion of food;
substitutes for gastric juice;
drugs to stimulate intestinal motility, which allows you to get rid of constipation;
vitamins;
probiotics and prebiotics to normalize microflora;
antibacterial drugs to combat Helicobacter pylori.

In combination with drug treatment, you can use folk remedies. With antacid gastritis, it is recommended to drink decoctions of St. John's wort, plantain, nettle, immortelle, yarrow, as well as cabbage juice.

Special diet

Proper nutrition means fractional food intake, refusal of fried, spicy, rough food, overeating. Experts recommend not to eat too cold or hot dishes, portions should be small, it is better to give preference to products that are responsible for stimulating the production of gastric juice. It is necessary to prepare meals by baking, stewing, boiling or steaming. It is allowed to include fruits and vegetables, lean fish and meat, dairy products, cereals in the menu. When it comes to forbidden foods, these include legumes, milk, strong tea and coffee, citrus fruits, whole grains, and fresh bread.

Important! Upon detection of this serious ailment, the patient must forever say goodbye to bad habits.

Due to the detection of the disease in the early stages of its development, it is possible to completely restore the work of the gastrointestinal tract for a not very long course of treatment. But if the disease has a chronic form, then it will not be possible to completely cure the patient, the therapy prescribed by the doctor only allows you to eliminate the symptoms of the disease and maintain the normal functioning of the digestive tract.

Consequences of the disease

In case of untimely treatment, a person suffering from antacid gastritis will experience a rapid thinning of the gastric mucosa, disruption of all digestive organs, which over time can lead to cancer, pancreatitis, ulcers and cholecystitis. In addition, the process of digestion of food will be disrupted, which will make it impossible for the body to absorb nutrients normally. A patient with an advanced ailment often has infectious diseases arising from the penetration of pathogenic microorganisms due to the fact that hydrochloric acid has ceased to be produced.

A person who cares about their health should understand that it is easier to prevent a disease than to cure it. Therefore, you should adhere to certain rules for the prevention of antacid gastritis, without waiting for the symptoms of the disease to appear. Preventive measures include rational nutrition, avoiding alcohol and cigarettes.

Proper nutrition will allow you to forget about all the unpleasant sensations that arise due to gastrointestinal problems, as well as improve your health. Remember, a balanced diet is the path to health!

If your stomach hurts what medicines to take

Treatment of pain in the stomach area is mainly based on the elimination of its main causative factors. Appropriate emergency measures are taken in situations of severe pain or life-threatening conditions.

In gastroenterological practice, specialists quite often include tablets in the treatment regimen to help cope with pain affecting the stomach.

Only experienced doctors can make an accurate diagnosis of a patient and tell him what to do and what drugs to take.

Causal factors of pain feelings

There are many causative factors that can have a detrimental effect on the stomach, and they all require completely different therapy.

By and large, the occurrence of pain in the abdominal region does not in all situations indicate the presence of a specific disease. Among the main factors of painful sensations are:

consumption of a very large amount of food, impaired bowel function, increased stress, stress (causing reflex cramps in the stomach), allergic manifestations;
ingestion of bacterial and viral agents (for example, in case of poisoning), which leads to symptoms such as diarrhea and fever;
trauma to the abdomen;
diseases associated with the kidneys, pancreas or liver, creating a false feeling of pain in the abdomen;
reaction to incorrect and poor diet.

All of the above reasons can significantly affect the work of the stomach and provoke the appearance of unpleasant pain sensations, and therefore it is necessary to take appropriate measures promptly and decide on the choice of pills that can stop the pain.

Pills for pain in the stomach area

Many people ask the question: what to do when the stomach hurts what pills to drink? There are a number of common and available medications that can relieve stomach pain and cramps.

Below are the most common medicines that can be used to relieve stomach pain.

Antacids

Parietal cells in the stomach wall are involved in the production of hydrochloric acid, which helps digest protein in food. The acid is highly aggressive for protein denaturation and digestion.

Other cells in the stomach create a mucus barrier to protect the stomach itself from its own natural acid.

When the latter bypasses the protective barriers of secreted mucus, pain sets in. Some medicines called antacids can help prevent the build-up of acid.

There are also specific antacids that neutralize acid. After the acid returns to normal levels, the pain usually subsides.

In the presence of gastritis or ulcers, accompanied by heartburn, sour belching and specific pain, you can drink medications like:

Gastala;
Almagel;
Anacid;
Maalox;
De-nola.

If, after taking these funds, unpleasant painful sensations have arisen, it is recommended to drink one of the enveloping preparations (like Phosphalugel).

If the process is accompanied by diarrhea and flatulence, it is necessary to drink any remedy like Linex.

Antibiotics

Bacteria such as Helicobacter pylori, E. coli, or Clostridium can cause stomach infections. According to various studies, H. pylori bacteria help reduce the protective properties of stomach mucus, causing pain from stomach acids.

Intestinal bacterial infections cause intestinal spasms as the latter tries to rid itself of the infection. Antibiotic drugs to eliminate bacterial infections can help relieve pain from them.

The choice of this type of medication with which you can cope with Helicobacter Pylori is not too large. Which ones are the most effective in fighting bacteria?

Today, the most famous are medications of the type:

Amoxicillin.
Clarithromycin.
Azithromycin.
Levofloxacin.

At the same time, it is known that an acidic environment is capable of deactivating most antibiotics.

In addition, certain antibiotic drugs and pills cannot work on the deeper layers of mucus, which contains the vast majority of bacterial agents.

Pain relievers

Pain relievers such as Aaracetamol and Acetaminophen (the same medicine, only with different names in different countries) can be taken to relieve moderate abdominal pain when it hurts in waves.

These medications are good for reducing the intensity of abdominal pain because they do not irritate the stomach lining, which can worsen the pain.

Other pain relievers, such as ibuprofen, can irritate the stomach area and make your stomach pain worse. Therefore, it is recommended that you consult your doctor before taking any pill.

Antispasmodic drugs

Sometimes, abdominal pain can be caused by muscle contraction in the digestive system. This type of pain is often described as "colic" or cramping pains.

They are a type of pain that starts and stops abruptly due to muscle contraction and relaxation in the digestive system.

Any antispasmodic agent works effectively by forcing the muscles to relax, thereby contributing to significant pain relief.

Antispasmodics are useful for relieving pain caused by flatulence and irritable bowel syndrome.

For cramps in the stomach, you can buy at the pharmacy and take the following medications:

Besalol.
Buscopan.
No-shpa.

Common antispasmodics for abdominal pain relief consist of Buscopan and Mebeverin. These pills should be taken only if the stomach hurts intensely and at the same time cramps are felt in it.

Anti-dyspeptic drugs

Diarrhea can cause abdominal pain, especially if it is due to a digestive tract infection.

Loperamide hydrochloride is a common drug used to treat acute diarrhea. It has a number of generic brands including Imodium.

Other medications

There are many other drugs, as well as various pills, designed to eliminate the specific causative factors of pain in the stomach.

They are prescribed by the attending physician or other healthcare professional (for example, a therapist or gastroenterologist).

For painful sensations provoked by the consumption of large amounts of food, especially against a background of low acidity or with indigestion, medications and pills are prescribed like:

Mezima forte;
Pancreatin;
Festala.

If the stomach hurts after taking any pill, there were probably violations in the rules for their use. Before using any pill, it is recommended that you read the instructions, since certain products should be taken exclusively after meals, while others should be washed down with a large volume of liquid.

If you neglect these rules, drugs in the form of tablets can irritate the stomach and its mucous membrane, which in the future can provoke the appearance of pain attacks.

Indications and contraindications for the use of tablets

Indications for the use of drugs in tablet form consist of:

High acidity of gastric juice, ulcers affecting the stomach.
Acute or chronic gastritis with high acidity.
Mild food poisoning.
Abdominal cramps.
Damage to the walls of the stomach, provoked by therapy with drugs that irritate the esophagus and stomach.
Stress-induced spasms.
Inflammation in the esophagus.

Contraindications consist of:

complex forms of renal function disorders;
individual intolerance to medications;
often - pregnancy and breastfeeding;
children's age category;
bleeding in the stomach.

A drug called No-shpa should not be prescribed during glaucoma or prostate hypertrophy, even if the stomach hurts badly. In other cases (severe stomach cramps), one tablet will suffice to relieve the condition.

Preparations in the form of tablets, which help to eliminate pain in the abdominal region, according to experts, are well tolerated by patients. However, in rare cases, certain patients may experience the following side effects:

dyspeptic phenomena, nausea and vomiting, stool disorders, changes in the shade of the tongue, darkening of feces;
allergic reactions in the form of edema, skin rashes.

Side effects are reversible and completely disappear after the completion of therapy with tablet drugs.

What to do if pills don't work

Constipation is another common cause of stomach pain and is usually treated with laxatives. Most constipation responds to prescription medications, however, in some cases, more aggressive treatment may be necessary after unsuccessful attempts to get rid of the condition.

In certain situations, constipation may require forced evacuation with an enema. The latter is defined as forcing water and stool from the intestine using an external plastic tube inserted into the rectum.

Enema kits can usually be purchased over the counter at most stores and pharmacies.

Some abdominal pain can be caused by a build-up of gas in the stomach. Gas associated with abdominal pain is usually treated with medications that contain simethicone, an active ingredient that reduces the amount of gas in the stomach.

Sometimes one tablet of this medication is enough to eliminate the corresponding symptom.

People who have chronic gas build up problems can take this medicine before meals, which can help prevent gas formation. The accumulation of gas in the stomach and associated pain can have many different causes, but they are often the result of overeating or eating too quickly.

In some situations, stomach pain may continue even after treatment with medication in the form of tablets for abdominal pain.

The main function of the gastrointestinal tract - the digestion of food - is carried out by the glands of the stomach. These tubes are responsible for the secretion of a variety of chemicals in gastric juices. There are several types of secretaries. In addition to the external glandular centers, there are internal endocrine centers that produce a special external secret. If at least one group fails, serious pathologies develop, so it is important to know their purpose and features.

Peculiarities

In order for the food coming from the esophagus to be well digested, it must be carefully prepared, rubbed into the smallest particles and processed with digestive juice. For this there are glands in the stomach. These are formations in the shell of the organ, which are tubules. They consist of a narrow (secretional part) and a wide (excretory) area. Glandular tissues secrete juice, consisting of many chemical elements necessary for digestion and preparation of food for entry into the duodenum.

Each section of the organ has its own glands:

primary processing of food coming from the esophagus into the cardiac zone;
the main loads that make up the fundic section;
secretory - cells that form a neutral chyme (food bolus) for entry into the intestine from the pyloric zone.

The glands are located in the epithelial membrane, which consists of a complex triple layer, including the epithelial, muscle, serous layer. The first two are designed to provide protection and motility, the last one is molded, external. The structure of the mucosa is distinguished by its relief with folds and pits, which protect the glands from the aggression of gastric contents. There are secretors that synthesize hydrochloric acid to provide the necessary acidity in the stomach. The glands of the stomach live only 4-6 days, after which they are replaced by new ones. The renewal of the secretors and the epithelial membrane occurs regularly due to the stem tissues located in the upper part of the glands.

Types of gastric glands

Pyloric

These centers are located at the junction of the stomach into the small intestine. The structure of glandular cells is branched with a large number of terminal tubules and wide lumens. The pyloric glands have endocrine and mucous secretors. Both components play a specific role: the endocrine centers do not secrete gastric juice, but control the work of the gastrointestinal tract and other organs, and the additional centers form mucus that dilutes the digestive juice in order to partially neutralize the acid.

Cardiac

They are located at the entrance to the organ. Their structure is formed from endocrine tubes with epithelial tubes. The task of the cardiac glands is the secretion of mucoid mucus with chlorides and bicarbonates, which is necessary to ensure the sliding of the food bolus. These mucous accessory secretors are also located at the bottom of the esophagus. They soften food as much as possible in preparation for digestion.

Own

They are numerous and cover the entire body of the stomach, line the fundus of the stomach. The fundic bodies are also called the own glands of the stomach. The tasks of these structures include the production of all components of gastric juice, in particular, pepsin - the main digestive enzyme. The fundic structure includes mucous, parietal, main, endocrine components.

With prolonged chronic inflammation, the stomach's own glands are reborn into cancerous ones.

The glands described above are exocrine glands that excrete secretions. There are also no endocrine centers that produce a secret that enters the lymph and bloodstream immediately. Based on the structure of gastric tissues, endocrine components are part of the exocrine glands. But their functions are strikingly different from those of the parietal elements. The endocrine glands are numerous (most of all in the pyloric region) and produce such substances for digestion and its regulation:

gastrin, pepsinogen, synthesized to increase the digestive activity of the stomach, mood hormone - enkephalin;
somatostatin, which secrete D-elements to inhibit the synthesis of protein, gastrin and other major digestive elements;
histamine - to stimulate the synthesis of hydrochloric acid (it also affects the vessels);
melatonin - for daily regulation of the gastrointestinal tract;
enkephalin - for pain relief;
vasointestinal peptide - to stimulate the pancreas and vasodilatation;
bombesin, produced by P-structures to increase the secretion of hydrogen chloride, the activity of the gallbladder, the production of appetite;
enteroglucagon, produced by A-centers to control the metabolism of carbohydrates in the liver, inhibition of gastric secretion;
serotonin, motilin, stimulated by enterochromaffin secretory centers, for the production of enzymes, mucus, activation of gastric motility.

The stomach is a difficult reservoir for temporary storage of food before serving it to the small intestine. In the organ, the food lump is carefully prepared for further advancement through the gastrointestinal tract. Some components are secreted in the stomach, which immediately enter the blood and lymph. Lumps of food are frayed, partially broken down and enveloped in bicarbonate mucus for unhindered, safe movement of food chyme into the intestines. Consequently, in this part of the digestive system, partial mechanical and chemical processing of food takes place.

The muscle layer of the stomach is responsible for mechanical splitting. Chemical preparation is carried out by gastric juice, which consists of enzymes and hydrochloric acid. These digestive components are secreted by the parietal glands of the stomach. The composition of the juice is aggressive, so it can dissolve even small cloves in a week. But without the special protective mucus produced by other glandular centers, the acid would corrode the stomach. Special protective mechanisms always work, and their strengthening occurs with a sharp jump in acidity, provoked by coarse, heavy or harmful food, alcohol or other factors. Failure of at least one mechanism leads to serious disorders in the mucous membrane, from which not only the stomach itself will suffer, but also the entire gastrointestinal tract.

The glandular centers of the stomach are responsible for special protective mechanisms, which form:

insoluble mucus, which contains the inner part of the gastric walls to create a barrier against the penetration of digestive juice into the tissues of the organ;
a mucous-alkaline layer localized in the submucosal layer, while the alkali concentration is equal to the acid content in the gastric juice;
a secret with special protective substances responsible for reducing the synthesis of hydrochloric acid, stimulating the production of mucus, optimizing blood flow, accelerating cell renewal.

Other defense mechanisms are:

cell regeneration every 3-6 days;
intense blood circulation;
antroduodenal brake, which blocks the passage of food chyme into the DCP during a jump in acidity up to the moment of pH stabilization.

It is extremely important to maintain optimal acidity in the stomach, since it is hydrochloric acid that provides an antimicrobial effect, the breakdown of food proteins, and regulates the activity of the organ. During the day, the parietal glands in the stomach secrete about 2.5 liters of hydrogen chloride. The acidity rate between meals is 1.6-2.0, after - 1.2-1.8. But if the balance of the protective and acid-forming functions is disturbed, the stomach lining is ulcerated.

The stomach is the most important organ of the digestive system, which takes part in chopping food masses and breaking down nutrients. Its peculiarity is that numerous stomach glands are located in the mucous membrane.

They not only produce hydrochloric acid and enzymes, but also biologically active substances that take part in the regulation of the digestive tract. The types of stomach glands, their location and functioning features are described below.

The stomach is a hollow organ located in the upper abdomen. It begins at the place where the lower edge of the esophagus passes into the cardiac part of the stomach (approximately at the level of 10 thoracic spine). This is where the sphincter is located, which prevents food from being thrown back into the upper digestive tract.

The cardiac region expands and passes into the body - the main part of the organ. This is where the main processes of digestion and grinding take place. The bottom extends slightly upward from the body - an area where air often accumulates. Below, the body gradually begins to narrow and passes into the pyloric section. Between it and the duodenum is the gatekeeper - a powerful smooth muscle sphincter that regulates the passage of food masses.

The wall consists of several layers:

Mucous membrane- formed by columnar epithelium. Under it is its own plate, which contains connective tissue and glandular cells.
Smooth muscle- consists of three balls of elastic muscles, which are located transversely to each other. This provides greater extensibility of the walls of the organ. Regular peristaltic movements greatly crush the food mass.
Adventitia shell, which is almost completely covered by the peritoneum.

Normally, the shape of the stomach is horn-like. Also distinguish between large and small curvature, anterior and posterior wall of the organ.

Features of stomach digestion

Digestion in the stomach consists of two processes:

crushing food mass due to powerful peristaltic movements of the organ wall;
enzymatic breakdown of carbohydrates and fats.

During a fasting meal, the production of gastric juice is reflexively triggered. First, it contains a large amount of proteolytic enzymes (pepsin). As the stomach fills, the histamine regulatory system is activated. Gradually, the composition of the juice changes - its acidity increases, the content of enzymes decreases. Hydrochloric acid, which the glands actively produce, destroys pathogenic microorganisms that enter with food.

But why doesn't the stomach digest itself? This does not happen due to the active production of mucus and bicarbonates, which cover the inner wall of the organ and protect it from the effects of hydrochloric acid.

Peristaltic movements (normally there are 2-6 of them per minute) contribute to the mechanical processing of food, as well as a gradual movement down the digestive system.

Interestingly, enzymes are produced in the stomach that are capable of breaking down only carbohydrates (pepsin, chymosin, gastrixin) and fats (lipase). Protein digestion takes place almost entirely in the intestine.

Types and functions of the gastric glands

The total number of glands in the stomach of a healthy adult patient reaches 15 million. Below is their main classification, which is used by gastroenterologists.

Own glands

This group includes the glands that are located in the body or the bottom. Quantitatively, they significantly prevail over all others. In the mucous membrane, there are groups of 2-8 glands, which open into small depressions - pits. They consist of several parts: a narrow neck, an elongated body and a bottom. They contain secretory cells of five types:

Pyloric glands

The pyloric glands are located in the stomach of the same name. They are tubular, have tortuous end sections. Their importance is to reduce the acidity of gastric contents before entering the duodenum. Therefore, parietal cells are completely absent here, and the main ones are represented in an insignificant amount.

The pyloric glands secrete bicarbonates, alkaline salts, and a large amount of mucus. Additionally, endocrine cells produce somatostatin, serotonin, motilin, substance P and enteroglucagon.

Cardiac glands

They are located in the cardiac section of the stomach. Morphologically and functionally, they are analogs of the glands located in the esophagus. They are characterized by highly developed ducts. They are composed mainly of mucous cells that produce mucus, as well as a significant amount of salts (mainly bicarbonates). Parietal and head cells are found here in small numbers, so the acidity in this part of the stomach is much lower than in the body.

Endocrine glands

The endocrine glands, which are located in the stomach, belong to the APUD system. It unites various endocrine cells that are located in the epithelium of the human digestive and respiratory systems. Consists of specific cells - apudocytes, which produce glandular hormones (small molecules of protein origin).

The largest number of endocrine cells is found in the body and pyloric region of the stomach.

The biologically active molecules that they produce take part in the regulation of the functioning of the digestive system:

gastrin- activates the production of pepsin, hydrochloric acid, increases acidity in the stomach;
somatostatin- a growth hormone;
histamine- stimulates the secretion of gastric juice, is one of the most important protective mediators of the mucous membrane;
substance P- increases motor activity and peristalsis of the stomach and postbulbar intestine;
serotonin- regulates the motility of the digestive system, the production of bile;
enteroglucagon- activates the processes of glycogenolysis in the liver.

The scheme of work of the glands

There are several mechanisms for regulating the work of the gastric glands:

Factors that affect the work of the glands

The following factors affect the work of the glands:

the nature of the diet;
psychoemotional state of the patient (activation of the sympathoadrenal system);
bad habits (alcohol abuse, smoking);
chronic inflammatory processes of the mucous membrane (gastritis);
long-term use of anti-inflammatory drugs;
chronic liver pathologies.

Stomach glands(gll. gastricae) in its various departments have an unequal structure. Distinguish three types of gastric glands : own glands of the stomach, pyloric and cardiac. Quantitatively, the own, or fundic, glands of the stomach predominate. They lie in the area of the body and the fundus of the stomach. The cardiac and pyloric glands are located in the parts of the stomach of the same name.

1. Own glands of the stomach (gll. gastricaepropriae) are the most numerous. In humans, there are about 35 million of them. The area of each gland is approximately 100 mm 2. The total secretory surface of the fundic glands reaches enormous sizes - about 3 ... 4 m 2. In structure, these glands are simple unbranched tubular glands. The length of one gland is about 0.65 mm, its diameter ranges from 30 to 50 microns. The glands open in clusters into the gastric dimples. In each gland, the isthmus (isthmus), the neck (cervix) and the main part (parsprincipalis), represented by the body (corpus) and the bottom (fundus), are distinguished. The body and bottom of the gland make up its secretory section, and the neck and isthmus of the gland make up its excretory duct. The lumen in the glands is very narrow and is almost invisible on the preparations.

The stomach's own glands contain 5 main types of glandular cells:

Main exocrinocytes,

Parietal exocrinocytes,

Mucous membranes, cervical mucocytes,

Endocrine (argyrophilic) cells,

· Undifferentiated epithelial cells.

Major exocrinocytes (exocrinocytiprincipales) are located mainly in areas of the bottom and body of the gland... The nuclei of these cells are rounded and lie in the center of the cell. The basal and apical parts are distinguished in the cell. The basal part has a pronounced basophilia. In the apical part, granules of protein secretion are found. A well-developed synthetic cell apparatus is located in the basal part. There are short microvilli on the apical surface. Secretory granules have a diameter of 0.9-1 microns. The main cells secrete pepsinogen- a proenzyme (zymogen), which in the presence of hydrochloric acid turns into an active form - pepsin. It is believed that chymosin, which breaks down milk proteins, is also produced by the host cells. When studying various phases of secretion of the main cells, it was revealed that in the active phase of production and accumulation of secretion, these cells are large, pepsinogen granules are clearly distinguishable in them. After secretion of the secretion, the size of the cells and the number of granules in their cytoplasm noticeably decrease. It has been experimentally proven that when the vagus nerve is stimulated, cells are quickly released from pepsinogen granules.

Parietal exocrinocytes (exocrinocytiparietales) are located outside of the main and mucous cells adjacent to their basal ends. They are larger than the main cells, of an irregular rounded shape. Parietal cells lie alone and are mainly concentrated in the area of the body and neck of the gland... The cytoplasm of these cells is sharply oxyphilic. Each cell contains one or two round-shaped nuclei lying in the central part of the cytoplasm. Inside the cells there are special intracellular tubule systems(canaliculisintracellulares) with numerous microvilli and small vesicles and tubes that form the tubulovesicular system, which plays an important role in transport Cl- -ions. Intracellular tubules pass into intercellular tubules located between the main and mucous cells and opening into the lumen of the gland. From the apical surface of the cells depart microvilli... Parietal cells are characterized by the presence of numerous mitochondria. The role of the parietal cells of the stomach's own glands is production of Н + -ions and chlorides from which hydrochloric acid is formed ( HCl).

Mucous cells, mucocytes (mucocyti), presented two kinds. Alone are located in the body of their own glands and have a compacted nucleus in the basal part of the cells. The apical part of these cells contains many round or oval granules, a small number of mitochondria, and the Golgi apparatus. Other mucous cells are located only in the neck of their own glands (the so-called. cervical mucocytes). Their nuclei are flattened, sometimes of an irregular triangular shape, usually lie at the base of the cells. In the apical part of these cells, there are secretory granules. The mucus secreted by the cervical cells is weakly stained with basic dyes, but is well detected by mucycarmine. Compared to the surface cells of the stomach, cervical cells are smaller and contain significantly fewer mucus droplets. Their secret differs in composition from the mucoid secretion secreted by the glandular epithelium of the stomach. In cervical cells, in contrast to other cells of the fundic glands, mitotic figures are often found. These cells are believed to be undifferentiated epithelial cells(epitheliocytinondifferentiati) - a source of regeneration of both the secretory epithelium of the glands and the epithelium of the gastric fossa.

Among the epithelial cells of the stomach's own glands there are also single endocrine cells belonging to the APUD-system.

2. Pyloric glands (gll. pyloricae) are located in the zone of transition of the stomach into the duodenum. Their number is about 3.5 million. The pyloric glands differ from their own glands in several ways: located more rarely, are branched, have wide gaps; most of the pyloric glands are devoid of parietal cells.

The end sections of the pyloric glands are built mainly of cells that resemble the mucous cells of their own glands. Their nuclei are flattened and lie at the base of the cells. In the cytoplasm, using special staining methods, mucus is detected. Pyloric gland cells are rich dipeptidases... The secret produced by the pyloric glands already has an alkaline reaction. In the neck of the glands there are also intermediate cervical cells.

The structure of the mucous membrane in the pyloric part has some peculiarities: the gastric dimples are deeper here than in the body of the stomach, and occupy about half of the entire thickness of the mucous membrane. Near the exit from the stomach, this membrane has a well-pronounced annular fold. Its occurrence is associated with the presence of a powerful circular layer in the muscular membrane that forms the pyloric sphincter. The latter regulates the flow of food from the stomach into the intestines.

3. Cardiac glands (gll. cardiacae) - simple tubular glands with highly branched end sections. The excretory ducts (necks) of these glands are short, lined with prismatic cells. The nuclei of cells are flattened and lie at the base of the cells. Their cytoplasm is light. With a special staining with mucicarmine, mucus is detected in it. Apparently, the secretory cells of these glands are identical to the cells lining the pyloric glands of the stomach and the cardiac glands of the esophagus. They also found dipeptidases... Sometimes the main and parietal cells are found in a small amount in the cardiac glands.

Gastrointestinal endocrinocytes (endocrinocytigastrointestinales).

Several types of endocrine cells have been identified in the stomach by morphological, biochemical and functional characteristics.

EC cells (enterochromaffin) - the most numerous, located in the area of the body and the bottom of the glands between the main cells. These cells secrete serotonin and melatonin. Serotonin stimulates the secretion of digestive enzymes, secretion of mucus, physical activity. Melatonin regulates the photoperiodicity of functional activity (i.e., depends on the action of the light cycle). G-cells (gastrin-producing) are also numerous and are found mainly in the pyloric glands, as well as in the cardiac, located in the region of their body and bottom, sometimes the neck. gastrin stimulates the secretion of pepsinogen by the main cells, hydrochloric acid - by parietal cells, and also stimulates gastric motility. With hypersecretion of gastric juice in humans, an increase in the number of G-cells is noted. In addition to gastrin, these cells secrete enkephalin, which is one of the endogenous morphines. He is credited with the role of pain mediation. Less numerous are P-, ECL-, D-, D 1 -, A- and X-cells. P-cells secrete bombesin, stimulating the secretion of hydrochloric acid and pancreatic juice, rich in enzymes, and also increase the contraction of the smooth muscles of the gallbladder. ECL cells (enterochromaffin-like) characterized by a variety of shapes and are located mainly in the body and fundic glands. These cells produce histamine, which regulates the secretory activity of parietal cells that release chlorides. D- and D 1 -cells come to light mainly in the pyloric glands. They are producers of active polypeptides. D cells allocate somatostatin inhibiting protein synthesis. D 1 cells secrete vasointestinal peptide (VIP), which dilates blood vessels and lowers blood pressure, and stimulates the secretion of pancreatic hormones. A cells synthesize glucagon, i.e. have a similar function to the endocrine A-cells of the islets of the pancreas.

2. Submucosa of the stomach comprises loose fibrous loose connective tissue containing a large number of elastic fibers... It contains the arterial and venous plexus, the network of lymphatic vessels and the submucous nerve plexus.

3. The muscular membrane of the stomach relatively poorly developed in the area of its bottom, well expressed in the body and reaches its greatest development in the gatekeeper. Distinguish in the muscular membrane three layers formed by smooth muscle cells. The outer, longitudinal, layer is a continuation of the longitudinal muscular layer of the esophagus. The middle - circular, also representing a continuation of the circular layer of the esophagus, reaches its greatest development in the pyloric region, where it forms a pyloric sphincter about 3-5 cm thick. The inner layer is represented by bundles of smooth muscle cells with an oblique direction. The intermuscular nerve plexus and the plexus of the lymphatic vessels are located between the layers of the muscular membrane.

4. Serous membrane of the stomach forms the outer part of its wall.

Vascularization. The arteries feeding the stomach wall pass through the serous and muscular membranes, giving them the corresponding branches, and then pass into a powerful plexus in the submucosa. Branches from this plexus penetrate through the muscle plate of the mucous membrane into its own plate and form a second plexus there. From this plexus, small arteries depart, continuing into the blood capillaries, braiding the glands and providing nutrition to the epithelium of the stomach. From the blood capillaries lying in the mucous membrane, blood is collected in small veins. Relatively large postcapillary stellate veins (w. Stellatae) pass directly under the epithelium. Damage to the epithelium of the stomach is usually accompanied by rupture of these veins and significant bleeding. The veins of the mucous membrane, coming together, form a plexus located in the lamina propria near the arterial plexus. The second venous plexus is located in the submucosa. All the veins of the stomach, starting with the veins lying in the mucous membrane, are equipped with valves. The lymphatic network of the stomach originates from the lymphatic capillaries, the blind ends of which are located directly under the epithelium of the gastric pits and glands in the lamina propria of the mucous membrane. This network communicates with a wide-looped network of lymphatic vessels located in the submucosa. Separate vessels depart from the lymphatic network, penetrating the muscular membrane. They are filled with lymphatic vessels from the plexuses lying between the muscle layers.

Medium, or gastroenteric, the section of the digestive tube includes the stomach, small and large intestines, liver and gallbladder, pancreas. In this section, food is digested under the action of enzymes of gastric and intestinal juices and the nutrients necessary for the body are absorbed.

Stomach performs a number of important functions associated with the chemical processing of food. Here, under the influence of gastric juice, active chemical breakdown of food begins. The components of gastric juice are pepsin, lipase, chymosin, as well as hydrochloric acid and mucus. The main enzyme in gastric juice, pepsin, breaks down complex food proteins into simple proteins. This happens only in an acidic environment, which is ensured by the production of hydrochloric acid. Lipase is involved in the breakdown of fats. Chimosin is produced in the stomach only in early childhood - it curdles milk.

For normal activities gastric mucosa it must be protected from the damaging effect of hydrochloric acid. This function is performed by mucus, which contains an acid-neutralizing substance (bicarbonate). In addition to the secretory function, the stomach also performs an excretory function, consisting in the release through the wall into the stomach cavity of a number of end products of protein metabolism (urea, ammonia, etc.), as well as heavy metal salts. Some substances (water, alcohol, salts, sugar, etc.) are absorbed in the stomach.

Suction function gastric mucosa however, is limited. It should also be noted that the protective (barrier) function of the gastric epithelium, which prevents the penetration of microbes into the blood, prevents self-digestion; motor, carried out by contraction of the muscular membrane, which is important for mixing food and moving it into the duodenum. The endocrine function of the stomach is of greater importance for the regulation of digestion.

Stomach development... The stomach is laid in the 4th week of embryogenesis, but the main processes of histogenesis occur during the 2nd month. At this time, the endodermal epithelium becomes monolayer, highly prismatic. During 6-10 weeks, epithelium derivatives - glands - are formed. However, by the time of birth, the process of differentiation of the gastric glands is not completed. The muscularis develops from the mesenchyme. The visceral sheet of the splanchnotome gives rise to the mesothelium. The stomach with all its membranes reaches its final development by 10-12 years.

The structure of the stomach... In the stomach of an adult, the following sections are distinguished: cardiac, fundic, the body of the stomach and the pyloric section. The wall of the stomach consists of the mucous membrane, submucosa, muscular and serous membranes. The mucous membrane of the stomach is about 1 mm thick and has an uneven surface. Its complex relief is due to the presence of folds, fields and pits. Along the lesser curvature of the stomach, the folds have a longitudinal direction (gastric track). The gastric fields are areas of the mucous membrane with groups of glands delimited by the grooves. The gastric pits are numerous depressions of the epithelium, into which 2-3 glands open. The total number of pits reaches almost 3 million. The inner surface of the stomach is covered with a single-layer highly prismatic epithelium of the intestinal type.

All epithelial cells are superficial epithelial cells, constantly secrete a mucus-like secret. A layer of mucus protects the mucous membrane from the mechanical effects of food and prevents the self-digestion of tissues by gastric juice. Under the action of irritating substances (alcohol, acids, etc.), the amount of mucus secreted increases significantly. Thus, the superficial epithelium of the stomach is a huge glandular field. The active surface of the gastric mucosa increases many times due to the presence of numerous and varied in structure gastric glands - own, pyloric and cardiac.

Stomach glands... In the gastric glands, the neck and the main part, consisting of the body and the bottom, are distinguished. The main part is the secretory section, and the neck is the excretory duct of the gland. In the cardiac, fundic and pyloric parts of the stomach, the glands have a different structure. Cardiac glands are simple tubular glands with highly branched end sections. They are located in the lamina propria of the gastric mucosa. The epithelium of the cardiac glands consists of mucous cells (mucocytes), as well as single parietal exocrinocytes and endocrinocytes.

Own glands of the stomach(fundic) are simple tubular unbranched glands located in the fundus and body of the stomach. These are the most abundant glands in the stomach. Their total number in humans is about 35 million. The neck of these glands contains cambial cells and cervical mucocytes. In the epithelial wall of the body and the bottom of the fundic glands, the main and parietal (parietal) exocrinocytes, mucocytes, endocrinocytes and poorly differentiated epithelial cells are distinguished.

Pyloric glands are tubular glands with short and branched end sections. They are located in the area of the gatekeeper. Between these glands, there are well-defined interlayers of the connective tissue of the mucous membrane. The epithelium of the pyloric glands is formed mainly by mucocytes and endocrinocytes. The pyloric glands are characterized by the fact that they open into deep gastric fossae.