Gastric mucosal integrity: gastric mucosal blood flow and microcirculation. An overview

The stomach is in a state of continuous exposure to potentially hazardous a gents. Hydrochloric acid together with pepsin constitutes a major and serio us threat to the gastric mucosa. Reflux of alkaline duodenal contents conta ining bile and pancreatic enzymes arc additional important injurious factor s of endogenous origin. Alcohol, cigarette smoking, drugs and particularly aspirin and aspirin-like drugs, and steriods are among exogenous mucosal ir ritants that can inflict mucosal injury. The ability of the stomach to defe nd itself against these noxious agents has been ascribed to a number of fac tors constituting the gastric mucosal defense. These include mucus and bica rbonate secreted by surface epithelial cells, prostaglandins, sulfhydryl co mpounds and gastric mucosal blood flow. The latter is considered by several researchers to be of paramount importance in maintainig gastric mucosal in tegrity. The aim of this paper is to review the experimental and clinical d ata dealing with the role of mucosal blood flow and in particular the micro circulation in both damage and protection of the gastric mucosa. (C) 2001 E lsevier Science Ltd. All rights reserved.