Univ. Bordeaux, INRA, EA 3671, CHU Bordeaux, 33000 Bordeaux
UVSQ, Inserm U-1173, Hôpital Ambroise-Paré, 92104, Boulogne-Billancourt, France
The gastric acidity acts as a barrier against microorganisms entering the stomach, facilitates the digestion of proteins, the absorption of non-heme iron, calcium and vitamin B12. The fundic and corporeal glands have parietal cells, which excrete protons in the gastric lumen via a specific pump. Acid secretion is finely regulated by various paracrine, hormonal and neuroendocrine mechanisms. The main stimulants of acid secretion are histamine, gastrin and acetylcholine. The main inhibitor is somatostatin. An imbalance in the regulation of acid secretion and/or protective mechanisms is responsible for ulcerative pathology. Helicobacter pylori is responsible for the occurrence of duodenal ulcers by increasing gastric acid secretion. PPIs, after cimetidine, have revolutionized the management of pathologies related to hyperacidity. They have an excellent safety profile, but their clinical use is imperfect, both in terms of indications and prescriptions.
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