Back-Diffusion – Fact or Fiction?

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Abstract
Alterations in the concentration of acid in gastric juice secreted at different flow rates and disappearance of acid from the gastric lumen, when the gastric mucosa is exposed to acid luminal contents, have been interpreted as indicating ‘back-diffusion’ of acid into the gastric mucosa from the luminal contents. The loss of acid from the gastric contents increases when the mucosa is exposed to certain drugs or is diseased, giving rise to the suggestion that the increased degree of ‘back-diffusion’ of acid indicates mucosal damage, reflecting a breakdown of the gastric mucosal ‘barrier’ to back-diffusion of acid from the gastric lumen. The change in the ‘barrier’ properties of the gastric mucosa has been found to be associated with change in the electrical properties of the mucosa, so that alterations of the transmucosal potential difference has been considered to denote gastric mucosal damage. The case for every one of these hypotheses and for their underlying assumptions is discussed and found wanting for lack of direct evidence.