Physiology Ellie was a high-school student who found herself in an extraordinari
ID: 3514831 • Letter: P
Question
Physiology
Ellie was a high-school student who found herself in an extraordinarily stressful situation. An excellent student, she was in the midst of applying to academically rigorous colleges while her family life continued to deteriorate. For six months, she had suffered from increasingly intense abdominal pain. It was high in her abdomen and came at times when her stomach was relatively empty. A typical episode would last for several hours. Sometimes she could continue her usual activities, but sometimes she was unable to remain in school or continue to study. Her physician learned little more from her physical examination, only that part of her abdomen was slightly tender to pressure. Routine screening tests were similarly unhelpful.
Only a few years ago, Ellie would have been diagnosed as having "acid peptic disease" due to too much acid secretion secondary to stress. But recent publications led her physician to order a blood test for antibodies to the bacterium Helicobacter pylori. The test came back positive. Subsequent endoscopy showed that she did not have a peptic ulcer but her stomach lining was rough and irritated. The presence in her stomach of H. pylori was established by biopsy. Ellie was treated with antimicrobial drugs to eliminate H. pylori and medication called a proton pump inhibitor to suppress all the acid production while treating the bacteria. Within a few weeks her abdominal pain disappeared, and she finished her senior year without further absences.
1. How does on acquire Helicobacter? Is it preventable?
2. What regulates proton pump activity? How would the abdominal pain felt during Helicobacter infection be similar or different to what is known as "heartburn"?
Explanation / Answer
1.H. pylori spread from person to person through fecal-oral or oral-oral routes(saliva or other body fluids). It's more common in countries or communities that lack clean water or good sewage systems H. pylori is also acquired from food, water, or utensils.to prevent the onset and spread of infection, it is always advisable for persons to wash hands thoroughly, to eat food that has been properly prepared, and to drink water from a safe, clean source
2. Proton pump activation in the parietal cells is regulated by gastric acid secretory capacity.The proton pump ( hydrogen potassium ATPase) is activated by gastrin(hormone which regulates secretion of gastric acid (HCl) by the parietal cells ) whcih releases histamine, which upon binding to the receptors on the parietal cell, causes the pump to change its localization and conformation to the active state.This class of proton pumps is driven by the hydrolysis of ATP which generates energy for the proton pump to drive the ions across the membrane
Heartburn is when stomach acid backs up into your esophagus which causes a burning feeling in the chest and is a symptom of acid reflux where the pain can move up from your stomach to the middle of your abdomen and chest.whereas due to inflammation of the stomach lining , they cause a sore, or stomach ulcer-causing nausea, vomiting or aching, burning stomach pain(usually upper abdomen) .