→ (1) The release of HCl (hydrochloric acid) is influenced by histamin, gastrin and acetylcholine. Peptic ulcers occur when there is a hypersecretion of HCl (and pepsin) from the parietal cells of the stomach.
→ Gastrin is a hormone released bt the stomach and duodenum for digestion.
→ These influencers act as proton pumps to move the HCl.
→ Aprox 2L of gastic juice a day
→ (2) Pepsin, a digestive enzyme, is activated at pH=2 and the pepsin-acid complex of gastric secretions can cause mucosal damage leading to ulcerration within hours.
→ (3) H. Pylori, a gram-negative bacteria, infect gastric mucosa leading to ulcers. Serology and breath tests can detect.
Serology usually refers to the diagnostic identification of antibodies in the serum. Such antibodies are typically formed in response to an infection (against a given microorganism).
Discuss antacid considerations.
→ Neutralize gastric acid/decrease pepsin production / raise pH to 3.5
→ Aluminum compounds: large doses needed, cause constipation
→ Al combines with phosphates - decreased phosphorus over time, but not an issue for renal Pt