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Water is a very minor source of hydrogen ions in comparison to carbonic acid. Carbonic acid is formed from carbon dioxide and water by carbonic anhydrase. The bicarbonate ion (HCO 3 −) is exchanged for a chloride ion (Cl −) on the basal side of the cell and the bicarbonate diffuses into the venous blood, leading to an alkaline tide phenomenon.
There is a risk of development of cancer with fundic gland polyposis, [22] but it varies based on the underlying cause of the polyposis. [4] The risk is highest with congenital polyposis syndromes, and is lowest in acquired causes. [4] [23] As a result, it is recommended that patients with multiple fundic polyps have a colonoscopy to evaluate ...
A derivative of timoprazole, omeprazole, was discovered in 1979, and was the first of a new class of drug that control acid secretion in the stomach, a proton pump inhibitor (PPI). [ 11 ] [ 12 ] Addition of 5-methoxy-substitution to the benzimidazole moiety of omeprazole was also made and gave the compound much more stability at neutral pH. [ 6 ]
Long-term use of PPIs is associated with the development of benign polyps from fundic glands (which is distinct from fundic gland polyposis); these polyps do not cause cancer and resolve when PPIs are discontinued. [33] There is concern that use of PPIs may mask gastric cancers or other serious gastric problems. [33]
Gastric polyps are adenomas that are usually asymptomatic and benign, but may be the cause of dyspepsia, heartburn, bleeding from the stomach, and, rarely, gastric outlet obstruction. [ 61 ] [ 71 ] Larger polyps may have become cancerous . [ 61 ]
A fundic gland polyp is a type of polyp, found in the fundus of the stomach. Fundic gland polyps are found in 0.8 to 1.9% of patients who undergo esophagogastroduodenoscopy, and are more common in middle-aged women. [2] The risk of malignancy is very low or none, when sporadic. [3]
The gastric hydrogen potassium ATPase or H + /K + ATPase is the proton pump of the stomach.It exchanges potassium from the intestinal lumen with cytoplasmic hydronium [2] and is the enzyme primarily responsible for the acidification of the stomach contents and the activation of the digestive enzyme pepsin [3] (see gastric acid).
PPI is the most popular agent in peptic ulcer prevention. [15] However, there is no evidence that H2 antagonists can prevent stomach bleeding for those taking NSAIDs. [15] Although misoprostol is effective in preventing peptic ulcer, its properties of promoting abortion and causing gastrointestinal distress limit its use. [15]