Hormonal regulation of gastric acid secretion.

Although gastric acid is not essential for life, it facilitates the digestion of protein and the absorption of iron, calcium, vitamin B(12), and thyroxin. It also prevents bacterial overgrowth and enteric infection. Gastric acid secretion must be precisely regulated, as too much acid may overwhelm mucosal defense mechanisms and lead to ulceration and maldigestion. The pathways regulating gastric acid secretion may be categorized as neural, paracrine, and hormonal; the hormonal pathways are the focus of this review. During meal ingestion, the main hormone responsible for stimulating acid secretion is gastrin, which acts primarily by releasing histamine from enterochromaffin-like cells. Ghrelin and orexin may also function as stimulatory hormones. Nutrients within the intestine, mainly lipid and protein, release peptide hormones such as cholecystokinin, secretin, neurotensin, and glucagon-like peptide, which may act in concert to inhibit acid secretion.