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rietal cells 32 development edit in the early part of the development of the human embryo the ventral part of the embryo abuts the yolk sac during the third week of development as the embryo grows it begins to surround parts of the yolk sac the enveloped portions form the basis for the adult gastrointestinal tract 33 the sac is surrounded by a network of vitelline arteries and veins over time these arteries consolidate into the three main arteries that supply the developing gastrointestinal tract the celiac artery superior mesenteric artery and inferior mesenteric artery the areas supplied by these arteries are used to define the foregut midgut and hindgut 33 the surrounded sac becomes the primitive gut sections of this gut begin to differentiate into the organs of the gastrointestinal tract and the esophagus and stomach form from the foregut 33 as the stomach rotates during early development the dorsal and ventral mesentery rotate with it this rotation produces a space anterior to the expanding stomach called the greater sac and a space posterior to the stomach called the lesser sac after this rotation the dorsal mesentery thins and forms the greater omentum which is attached to the greater curvature of the stomach the ventral mesentery forms the lesser omentum and is attached to the developing liver in the adult these connective structures of omentum and mesentery form the peritoneum and act as an insulating and protective layer while also supplying organs with blood and lymph vessels as well as nerves 34 arterial supply to all these structures is from the celiac trunk and venous drainage is by the portal venous system lymph from these organs is drained to the prevertebral celiac nodes at the origin of the celiac artery from the aorta function edit digestion edit further information human digestive system see also gastric acid in the human digestive system a bolus a small rounded mass of chewed up food enters the stomach through the esophagus via the lower esophageal sphincter the stomach releases proteases protein digesting enzymes such as pepsin and hydrochloric acid which kills or inhibits bacteria and provides the acidic ph of 2 for the proteases to work food is churned by the stomach through peristaltic muscular contractions of the wall reducing the volume of the bolus before looping around the fundus 35 and the body of stomach as the boluses are converted into chyme partially digested food chyme slowly passes through the pyloric sphincter and into the duodenum of the small intestine where the extraction of nutrients begins gastric juice in the stomach contains pepsinogen and gastric acid hydrochloric acid which activates this inactive form of enzyme into the active form pepsin pepsin breaks down proteins into polypeptides mechanical digestion edit within a few moments after food enters the stomach mixing waves begin to occur at intervals of approximately 20 seconds a mixing wave is a unique type of peristalsis that mixes and softens the food with gastric juices to create chyme the initial mixing waves are relatively gentle but these are followed by more intense waves starting at the body of the stomach and increasing in force as they reach the pylorus the pylorus which holds around 30 ml of chyme acts as a filter permitting only liquids and small food particles to pass through the mostly but not fully closed pyloric sphincter in a process called gastric emptying rhythmic mixing waves force about 3 ml of chyme at a time through the pyloric sphincter and into the duodenum release of a greater amount of chyme at one time would overwhelm the capacity of the small intestine to handle it the rest of the chyme is pushed back into the body of the stomach where it continues mixing this process is repeated when the next mixing waves force more chyme into the duodenum gastric emptying is regulated by both the stomach and the duodenum the presence of chyme in the duodenum activates receptors that inhibit gastric secretion this prevents additional chyme from being released by the stomach before the duodenum is ready to process it 36 chemical digestion edit the fundus stores both undigested food and gases that are released during the process of chemical digestion food may sit in the fundus of the stomach for a while before being mixed with the chyme while the food is in the fundus the digestive activities of salivary amylase continue until the food begins mixing with the acidic chyme ultimately mixing waves incorporate this food with the chyme the acidity of which inactivates salivary amylase and activates lingual lipase lingual lipase then begins breaking down triglycerides into free fatty acids and mono and diglycerides the breakdown of protein begins in the stomach through the actions of hydrochloric acid and the enzyme pepsin the stomach can also produce gastric lipase which can help digesting fat the contents of the stomach are completely emptied into the duodenum within two to four hours after the meal is eaten different types of food take different amounts of time to process foods heavy in carbohydrates empty fastest followed by high protein foods meals with a high triglyceride content remain in the stomach the longest since enzymes in the small intestine digest fats slowly food can stay in the stomach for 6 hours or longer when the duodenum is processing fatty chyme however this is still a fraction of the 24 to 72 hours that full digestion typically takes from start to finish 36 absorption edit although the absorption in the human digestive system is mainly a function of the small intestine some absorption of certain small molecules nevertheless does occur in the stomach through its lining this includes water if the body is dehydrated medication such as aspirin amino acids 37 10 20 of ingested ethanol e g from alcoholic beverages 38 caffeine 39 to a small extent water soluble vitamins most are absorbed in the small intestine 40 the parietal cells of the human stomach are responsible for producing intrinsic factor which is necessary for the absorption of vitamin b12 b12 is used in cellular metabolism and is necessary for the production of red blood cells and the functioning of the nervous system control of secretion and motility edit emptying of stomach chyme into the duodenum through the pyloric sphincter chyme from the stomach is slowly released into the duodenum through coordinated peristalsis and opening of the pyloric sphincter the movement and the flow of chemicals into the stomach are controlled by both the autonomic nervous system and by the various digestive hormones of the digestive system gastrin the hormone gastrin causes an increase in the secretion of hcl from the parietal cells and pepsinogen from chief cells in the stomach it also causes increased motility in the stomach gastrin is released by g cells in the stomach in response to distension of the antrum and digestive products especially large quantities of incompletely digested proteins it is inhibited by a ph normally less than 4 high acid as well as the hormone somatostatin cholecystokinin cholecystokinin cck has most effect on the gall bladder causing gall bladder contractions but it also decreases gastric emptying and increases release of pancreatic juice which is alkaline and neutralizes the chyme cck is synthesized by i cells in the mucosal epithelium of the small intestine secretin in a different and rare manner secretin which has the most effects on the pancreas also diminishes acid secretion in the stomach secretin is synthesized by s cells which are located in the duodenal mucosa as well as in the jejunal mucosa in smaller numbers gastric inhibitory polypeptide gastric inhibitory polypeptide gip decreases both gastric acid release and motility gip is synthesized by k cells which are located in the duodenal and jejunal mucosa enteroglucagon enteroglucagon decreases both gastric acid and motility other than gastrin these hormones all act to turn off the stomach action this is in response to food products in the liver and gall bladder which have not yet been absorbed the stomach needs to push food into the small intestine only when the intestine is not busy while the intestine is full and still digesting food the stomach acts as storage for food other edit effects of egf epidermal growth factor egf results in cellular proliferation differentiation and survival 41 egf is a low molecular weight polypeptide first purified from the mouse submandibular gland but since then found in many human tissues including the submandibular gland and the parotid gland salivary egf which also seems to be regulated by dietary inorganic iodine also plays an important physiological role in the maintenance of oro esophageal and gastric tissue integrity the biological effects of salivary egf include healing of oral and gastroesophageal ulcers inhibition of gastric acid secretion stimulation of dna synthesis and mucosal protection from intraluminal injurious factors such as gastric acid bile acids pepsin and trypsin and from physical chemical and bacterial agents 42 stomach as nutrition sensor the human stomach has receptors responsive to sodium glutamate 43 and this information is passed to the lateral hypothalamus and limbic system in the brain as a palatability signal through the vagus nerve 44 the stomach can also sense independently of tongue and oral taste receptors glucose 45 carbohydrates 46 proteins 46 and fats 47 this allows the brain to link nutritional value of foods to their tastes 45 thyrogastric syndrome this syndrome defines the association between thyroid disease and chronic gastritis which was first described in the 1960s 48 this term was coined also to indicate the presence of thyroid autoantibodies or autoimmune thyroid disease in patients with pernicious anemia a late clinical stage of atrophic gastritis 49 in 1993 a more complete investigation on the stomach and thyroid was published 50 reporting that the thyroid is embryogenetically and phylogenetically derived from a primitive stomach and that the thyroid cells such as primitive gastroenteric cells migrated and specialized in uptake of iodide and in storage and elaboration of iodine compounds during vertebrate evolution in fact the stomach and thyroid share iodine concentrating ability and many morphological and functional similarities such as cell polarity and apical microvilli similar organ specific antigens and associated autoimmune diseases secretion of glycoproteins thyroglobulin and mucin and peptide hormones the digesting and readsorbing ability and lastly similar ability to form iodotyrosines by peroxidase activity where iodide acts as an electron donor in the presence of h 2 o 2 in the following years many researchers published reviews about this syndrome 51 clinical significance edit an endoscopy of a normal stomach of a healthy 65 year old woman endoscopic image of a fundic gland polyp diseases edit main article stomach disease a series of radiographs can be used to examine the stomach for various disorders this will often include the use of a barium swallow another method of examination of the stomach is the use of an endoscope a gastric emptying study is considered the gold standard to assess the gastric emptying rate 52 a large number of studies have indicated that most cases of peptic ulcers and gastritis in humans are caused by helicobacter pylori infection and an association has been seen with the development of stomach cancer 53 a stomach rumble is actually noise from the intestines surgery edit in humans many bariatric surgery procedures involve the stomach in order to lose weight a gastric band may be placed around the cardia area which can adjust to limit intake the anatomy of the stomach may be modified or the stomach may be bypassed entirely surgical removal of the stomach is called a gastrectomy and removal of the cardia area is a called a cardiectomy cardiectomy is a term that is also used to describe the removal of the heart 54 55 56 a gastrectomy may be carried out because of gastric cancer or severe perforation of the stomach wall fundoplication is stomach surgery in which the fundus is wrapped around the lower esophagus and stitched into place it is used to treat gastroesophageal reflux disease gerd 57 etymology edit the word stomach is derived from greek stomachos στόμαχος ultimately from stoma στόμα mouth 58 gastro and gastric meaning related to the stomach are both derived from greek gaster γαστήρ belly 59 60 61 other animals edit although the precise shape and size of the stomach varies widely among different vertebrates the relative positions of the esophageal and duodenal openings remain relatively constant as a result the organ always curves somewhat to the left before curving back to meet the pyloric sphincter however lampreys hagfishes chimaeras lungfishes and some teleost fish have no stomach at all with the esophagus opening directly into the intestine these animals all consume diets that require little storage of food no predigestion with gastric juices or both 62 comparison of stomach glandular regions from several mammalian species frequency of glands may vary more smoothly between regions than is diagrammed here asterisk ruminant represents the omasum which is absent in tylopoda tylopoda also have some cardiac glands opening onto ventral reticulum and rumen 63 many other variations exist among the mammals 64 65 yellow esophagus green esophageal nonglandular region 66 purple cardiac gland region 66 red fundic gland region 66 blue pyloric gland region 66 dark blue duodenum the gastric lining is usually divided into two regions an anterior portion lined by fundic glands and a posterior portion lined with pyloric glands cardiac glands are unique to mammals and even then are absent in a number of species the distributions of these glands vary between species and do not always correspond with the same regions as in humans furthermore in many non human mammals a portion of the stomach anterior to the cardiac glands is lined with epithelium essentially identical to that of the esophagus ruminants in particular have a complex four chambered stomach the first three chambers rumen reticulum and omasum are all lined with esophageal mucosa 62 while the final chamber functions like a monogastric stomach which is called the abomasum in birds and crocodilians the stomach is divided into two regions anteriorly is a narrow tubular region the proventriculus lined by fundic glands and connecting the true stomach to the crop beyond lies the powerful muscular gizzard lined by pyloric glands and in some species containing stones that the animal swallows to help grind up food 62 in insects there is also a crop the insect stomach is called the midgut information about the stomach in echinoderms or molluscs can be found under the respective articles additional images edit image showing the celiac artery and its branches a human stomach at autopsy showing the many folds...
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