Divergent results from in vitro studies on the thickness and appearance of the gastrointestinal mucus layer have previously been reported. With an in vivo model, we studied mucus gel thickness over time from stomach to colon. The gastrointestinal tissues of Inactin-anesthetized rats were mounted luminal side up for intravital microscopy. Mucus thickness was measured with a micropipette before and after mucus removal by suction. The mucus layer was translucent and continuous; it was thickest in the colon (approximately 830 microm) and thinnest in the jejunum (approximately 123 microm). On mucus removal, a continuous, firmly adherent mucus layer remained attached to the epithelial surface in the corpus (approximately 80 microm), antrum (approximately 154 microm), and colon (approximately 116 microm). In the small intestine, this layer was very thin (approximately 20 microm) or absent. After mucus removal, there was a continuous increase in mucus thickness with the highest rate in the colon and the lowest rate in the stomach. In conclusion, the adherent gastrointestinal mucus gel in vivo is continuous and can be divided into two layers: a loosely adherent layer removable by suction and a layer firmly attached to the mucosa.

Mucus thickness is suggested to be related to mucosal protection. We therefore investigated the importance of the removable mucous layer and epithelial bicarbonate transport in preservation of the gastric juxtamucosal pH (pH(jm)) during luminal acid. Anesthetized rats were prepared for intravital microscopy of the gastric mucosa, and pH(jm) was measured with pH-sensitive microelectrodes. The mucus was either left intact (IM) or removed (MR) down to the firmly attached mucous layer, and HCl (pH 1) was applied luminally. Removal of the loosely adherent mucous layer did not influence the pH(jm) during luminal acid (pentagastrin: IM/MR 7.03 +/- 0.09/6.82 +/- 0.19; pentagastrin + indomethacin: IM/MR 6.89 +/- 0.20/6.95 +/- 0.27; ranitidine: IM/MR 2.38 +/- 0.64/2.97 +/- 0.62), unless prostaglandin synthesis and acid secretion were inhibited (ranitidine + indomethacin: IM/MR 2.03 +/- 0.37/1.66 +/- 0.18). Neutral pH(jm) is maintained during endogenous acid secretion and luminal pH 1, unless DIDS was applied luminally, which resulted in a substantially decreased pH(jm) (1.37 +/- 0.21). Neutral pH(jm) is maintained by a DIDS-sensitive bicarbonate transport over the surface epithelium. The loosely adherent mucous layer only contributes to maintaining pH(jm) during luminal pH 1 if acid secretion and prostaglandin synthesis are inhibited.

The reduction in mucosal blood flow induced by the extract was probably mediated through an acute inflammatory response involving mast cell degranulation with consequent PAF secretion. The effect on blood flow was not the result of a decrease in vascular tone due to an inhibition of endogenous NO biosynthesis.

A H pylori water extract reduces gastric mucosal blood flow acutely through iNOS- and nerve-mediated pathways.

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A factor or a combination of factors, other than VacA and CagA released from H. pylori, might compromise the natural defence of the gastric corporal mucosa by reducing mucosal blood flow. The factor is heat-stable and lacking or less potent in E. coli.