The stomach in health and disease

Abstract

The stomach is traditionally regarded as a hollow muscular sac that initiates the second phase of digestion. Yet this simple view ignores the fact that it is the most sophisticated endocrine organ with unique physiology, biochemistry, immunology and microbiology. All ingested materials, including our nutrition, have to negotiate this organ first, and as such, the stomach is arguably the most important segment within the GI tract. The unique biological function of gastric acid secretion not only initiates the digestive process but also acts as a first line of defence against food-borne microbes. Normal gastric physiology and morphology may be disrupted by Helicobacter pylori infection, the most common chronic bacterial infection in the world and the aetiological agent for most peptic ulcers and gastric cancer. In this state-of-the-art review, the most relevant new aspects of the stomach in health and disease are addressed. Topics include gastric physiology and the role of gastric dysmotility in dyspepsia and gastroparesis; the stomach in appetite control and obesity; there is an update on the immunology of the stomach and the emerging field of the gastric microbiome. H. pylori-induced gastritis and its associated diseases including peptic ulcers and gastric cancer are addressed together with advances in diagnosis. The conclusions provide a future approach to gastric diseases underpinned by the concept that a healthy stomach is the gateway to a healthy and balanced host. This philosophy should reinforce any public health efforts designed to eradicate major gastric diseases, including stomach cancer.

Higher Frequency of Reflux Symptoms and Acid-Related Dyspepsia in Women than Men Regardless of Endoscopic Esophagitis: Analysis of 3,505 Japanese Subjects Undergoing Medical Health Checkups

“…The lesser number of subjects with gastroduodenal ulcers might be a major reason for the lack of a relationship between gastroduodenal ulcers and upper gastrointestinal symptoms. The presence of relationship between H. pylori infection and dyspepsia symptoms was controversial in several studies [20][21][22] , and this study suggests that H. pylori infection does not influence the development of acid-related dyspepsia in the general population of Japan.…”

Exercise has the guts: How physical activity may positively modulate gut microbiota in chronic and immune-based diseases

“…Altogether, this involvement suggested a role of microbiota in the gut-brain axis, and appetite control. Furthermore, butyrate has been evoked for anticancer effects, anti-inflammatory properties and energy expenditure [30,31].…”

Introductory Chapter: Stomach-Beyond Digestion

“…Thankfully, we have an amazing stomach, which can function as a sterilizer by creating a highly acidic environment inside our body and keeping its acidity around pH 2.0 for most of the time. Pathogens can rarely survive through such a harsh condition [8]. That eliminates numerous risks we might have to deal with otherwise.…”