Determinants of acid secretion.

ABSTRACT

Acid secretion is regulated by hormonal factors acting peripherally and centrally, as well as neural factors. Gastrin and histamine are the two most important peripheral hormonal stimulants, while the vagus is the predominant nerve affecting acid secretion. Meal related acid secretion occurs in three phases cephalic, gastric and intestinal. Acid secretion is stimulated in the first two phases while it is inhibited in the intestinal phase. Proteins are potent acid stimulants but carbohydrates and fats are inhibitors. Tea, coffee, milk and alcohol are acid stimulants; on the other hand the damaging influence of spices on the stomach may not be related to increased acid secretion. Psychological stress has a variable effect. The effect of Helicobacter pylori infection on acid secretion is being elucidated. Many drugs modifying acid secretion are available and are useful in the treatment of acid peptic disease.