Gastric Hypersecretion Syndrome
This is a typical functional disorder of the stomach characterized by an excessive increase in the volume of gastric juice produced. This process is always accompanied by an increase in secretory acidity and a sharp rise in its digestive capacity.
The main causes of hypersecretion include:
- Increased mass of gastric secretory cells (in most cases, a genetically determined trait).
- Enhanced vagal stimulation, frequently observed in various neurotic states and constitutional vagotonia.
- Elevated gastrin synthesis and potentiation of its physiological effects.
- Hypertrophy or hyperplasia of enterochromaffin-like cells (enteroendocrine elements), a typical histological feature of hypertrophic gastritis.
- Gastric antral distension caused by food masses.
- Iatrogenic factors: the use of certain drugs, particularly acetylsalicylic acid or glucocorticoids.
Pathological consequences of hypersecretion include marked slowing of gastric emptying. Aggressive acidic juice causes erosions and ulcerations of the mucosa, clinically accompanied by heartburn. Gastroesophageal reflux also develops. Furthermore, excess acid triggers intestinal digestive disorders leading to malabsorption syndrome.
Gastric Hyposecretion
This typical secretory disorder manifests as a noticeable decrease in the volume of secreted juice, combined with reduced acidity and a drop in digestive capacity.
The main causes of hyposecretion include:
- Decreased secretory cell mass (observed in hypotrophic and atrophic forms of chronic gastritis, as well as in disintegrating gastric tumors).
- Reduced vagal stimulation (characteristic of neuroses and constitutional sympathicotonia).
- Decreased gastrin production or blockade of its effects.
- Dietary factors: severe bodily deficiency in proteins and vitamins.
- Drug action, specifically medications that reduce or completely eliminate vagal effects (e.g., cholinoceptor blockers or cholinesterase activators).
Gastric Achylia: Extreme Secretory Suppression
Gastric achylia is a typical secretory dysfunction characterized by an inadequate amount or a complete absence of gastric juice (including hydrochloric acid, pepsin, and other essential components).
The etiology of achylia is identical to the causes of hyposecretion. The difference lies in the intensity of the insult: in achylia, pathogenic factors act much more severely, causing profound suppression of gastric secretory function.
The main pathological consequences of achylia include:
- Pathological acceleration of gastric emptying.
- Secondary exocrine pancreatic insufficiency.
- Global digestive disorders within the intestinal lumen.
- Development of severe anemia (pernicious or iron-deficiency types).
- High risk of gastric cancer.