OBVIOUSLY the stomach does not digest itself. But why not? If you were to cut out a little piece of a stomach and drop it into some normal gastric juice it would be digested. Actually, this is what happens in the development of an ulcer, or its precursor, an erosion. The mixture of hydrochloric (muriatic) acid and pepsin, the protein-digesting enzyme made by the stomach, begins to digest the cells that line the inside layer of the stomach. If this is not arrested, the process may erode deeper and deeper, until it penetrates entirely through the stomach wall and sometimes spills some of its contents into the abdominal cavity. This is a very serious complication and results in peritonitis. Nor are blood vessels in the path of the ulcer preserved from the effects of the corrosive fluid, and intermittent blood loss or massive hemorrhage may result.
There seems to be a continual tug of war between aggressive forces tending to damage the stomach, and its ability to resist these forces. Whether a person has an ulcer at any given time is a result of the balance between these forces. Among the factors preserving the soundness of the stomach wall, two are of special interest—the health of the delicate membrane (mucosa) that lines its inside, and the integrity of the layer of mucus that normally coats the mucosa.
The surface of the mucosa is pin-pricked by millions of tiny pits—62,500 per square inch. These are the mouths of minute test-tube-shaped glands com posed of the cells that make the incredibly potent digestive chemicals of the stomach (Fig. 1). Of these, hydrochloric acid, pepsin, and mucus are of particular importance in the balance between protein digestion and stomach protection. Each is made by a different kind of cell. Those that synthesize acid and pepsin are located in the depths of the pits, while those that make the mucus are just under the surface of the stomach. Normally, acid moves from the mucosa into the stomach with incredible speed, while only a small amount of hydrogen (the hallmark of an acid) seeps back into the mucosa. If it were to accumulate to any degree inside the cells, it would damage them.
Protected by Mucus
One of the functions of mucus is to prevent rapid re-entry of acid. Up to an eighth of an inch thick, this mucous layer is extremely sticky and tenacious. Because it is very alkaline, it can neutralize much of the acidity of the gastric juice. It also inhibits the protein digesting action of the pepsin. 1 Thus it forms a protective coat for the inside of the stomach. Actually, the entire digestive tract from mouth to rectum is protected by mucus.
The complex of the mucus plus the cells that lie just beneath is called the mucosal barrier, and an effective barrier it is against damage by digestive juice or other harmful substances. A healthy mucosa, covered by a good layer of thick mucus, is most unlikely to be affected by erosions or ulcers. But let something happen to this barrier, and the stomach will digest itself.
What can happen to the cells? Scientists think that if their blood supply is too scanty, the mucosa may be more easily attacked by digestive fluids. Worry, anxiety, and fear tend to make the tiny blood vessels of the mucosa contract, thus diminishing its blood supply. Some drugs have the same effect. On the other hand, when the mucosa is engorged with excessive blood (such emotions as anger and rage can cause engorgement in some, if not all, people) it is much more fragile and easily damaged than usual.
Laboratory animals that have been fed a diet deficient in vitamin Be (pantothenic acid) develop more ulcers than animals on an adequate amount of this vitamin, and the ulcers heal rapidly if it is supplied.2
Some of us have enough protection to handle average amounts of acid and pepsin, but not enough for excessive amounts. Caffeine, meat extractives (the substances in meat that give its characteristic flavors), alcohol, and certain drugs stimulate the stomach to make abnormally large amounts of acid and pepsin. At least in some people, in tense prolonged stress, anger, or rage can have the same effect. Another significant and common reason for the stomach's digesting itself is damage to the mucosal barrier. A number of nonfoods that are commonly put into the stomach for various reasons are known to do this. "Acid" then accumulates in the mucosal cells, thus initiating a chain of events that can make an erosion or ulcer.
Among the substances that can do this are cortisone, ordinary aspirin, eugenol (that delightfully fragrant chemical found in certain spices, among them cloves, allspice, and cinnamon), acetic acid (the essential component of vinegar), and alcohol. Many physicians have found by experience that their ulcer patients do better without spicy food. The complicating development of bleeding ulcers in patients taking cortisone for rheumatoid arthritis is as well known as it is that aspirin predisposes to ulcers. What is not so well known is that many persons who habitually take even a small amount of aspirin have a continual, though usually unrecognized, loss of blood from their digestive tract. If acetic acid is applied to the mucosa of laboratory animals for a short time, or injected into the mucosa, ulcers invariably result.3
The way mucosal cells are damaged by the rapid re-entry of many hydrogen ions through the broken barrier is diagrammed in Figure 2.
Effect of Stress
The amount of mucus itself, as well as its presence deep down in the pits of the mucosa, is very definitely decreased in laboratory rats by restraining them for twenty-four hours—a very stressful condition for a rat.4 This may be the reason for the well-known fact that people who have periods of severe stress seem to have more ulcers. Add to this the in crease in acid and pepsin that stress induces in some people, and you have the stage set for the appearance of ulcers more acid and less protection.
A healthy mucosal barrier should be most highly prized. Ulcers are not only extremely painful but also sabotage energy, time, and money. What can you do to protect your stomach? Overcome stress, worry, rage, and all their relatives with trust and love, and deal appropriately with the cause. Avoid those foods or non-foods that may damage your mucosal barrier and cause your stomach to produce excessive amounts of acid and pepsin. Eat only at regular mealtimes, for food in the stomach causes it to continue secreting. There is no need to keep producing all through the day and night the quantities of acid and pepsin needed to digest meals.
A happy stomach contributes more than most people realize to a happy dis position and more effective ministry. The classic Counsels on Diet and Foods promises us, "Respect paid to the proper treatment of the stomach will be re warded in clearness of thought and strength of mind. Your digestive organs will not be prematurely worn out to testify against you." —Page 101.
The same writer adds, "If we would have peace among ourselves, we should give more thought than we do to having a peaceful stomach." —Ibid., p. 112. One of the best preventive measures is found in the words of the ancient wise man. If we would enjoy health in its truest sense we must "trust in the Lord with all thine heart; and lean not unto thine own understanding" (Prov. 3:5). Nothing brings peace and the attend ant blessing of health more than the religion of Christ. Unless we enjoy a confident, trusting, peaceful relationship with God the tensions of ministerial duties are likely to cause our stomachs to start digesting themselves.
Notes:
1 J. DeGraef, "Physiology and Physiopathology of Sulfated Glycoprotein and Sulfated Polysaccharide Secretion by the Gastric Mucosa in the Dog," in Carl J. Pfeiffer (ed.), Peptic Ulcer (Philadelphia: J. B. Lippincott Company, 1971), p. 160.
2 J. Seronde, Jr., "The Zucker Ulcer: The Duodenal Ulcer of Pantothenate Deficiency," ibid., pp. 3-12.
3 S. Okabe and C. J. Pfeiffer, "The Acetic Acid Ulcer Model—a Procedure for Chronic Duodenal or Gastric Ulcer," ibid., pp. 13-20.
4 R. Lambert, K. Truchot, C. Andre, and J. A. Chayvialle, "A Histological Study of Glycoproteins in the Gastric Mucosa of Restrained Rats," ibid., pp. 145-154.
