Patients
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| absorption | uptake of a material (drug for example) from the stomach or intestine into the bloodstream |
| acid rebound | surge of gastric acid after a period of time when the stomach pH was not acidic; typically caused by fast-acting antacids that are potent enough to raise the stomach pH above 5 |
| activation | the process in which a drug is stimulated to undergo a chemical change so that it can react with its target; see degradation |
| acute dystonic reactions | involuntary rigidity and/or spasmodic movements in one or more parts of the body; a side-effect of drugs that affect dopamine receptors such as metoclopramide; see rigid body posturing page |
| apex/apical end (of parietal cell) | the “top”; the portion that opens into the gastric gland and releases stomach acid into the stomach; the site of the canaliculus, location of active proton pumps and acid production |
| arrhythmia | an irregularity in the rhythm of the heartbeat |
| aspiration | inhaling liquid or vapor into the airway |
| Barrett’s Esophagus | a type of metaplasia (transformation from one cell type to another) in which the lining of the esophagus changes to mimic that of the stomach, in order to protect itself from acid reflux; it is generally a sign of concern as this can be a precancerous state |
| basal | the resting or inactive state of a parietal cell in which minimal acid is produced; the tubulovesicular state |
| blood-brain barrier | filter that allows only certain materials to cross from the bloodstream to the brain, protecting it from potentially harmful substances; in drug development, this may be an obstacle or a benefit: some drugs are intended to cross the barrier while others are not because they could trigger harmful neural side-effects |
| buffer | a neutralizing solution; naturally occurring in the body, or used in pharmaceutics to protect medication from stomach acid degradation |
| canaliculus | the characteristic shape (an invagination or canal throughout) of a parietal cell as it produces stomach acid; its walls house active proton pumps; a parietal cell is said to be in an active or canalicular state while the canaliculus is present; see tubulovesicle |
| cell membrane | external wall of a cell |
| chyme | partially digested food that passes from the stomach to the duodenum |
| degradation | the process in which a drug undergoes a chemical change in a manner that makes it unstable; see activation |
| delayed-release | any drug encapsulated by a protective enteric-coating, which delays its absorption into the bloodstream; see immediate-release |
| duodenum | first 10-12 inches of the small intestine just past the stomach |
| dyspepsia | indigestion and heartburn |
| ECL cell | a cell in the stomach lining that releases histamine in order to stimulate the parietal cell to begin producing acid; the ECL cell is stimulated by gastrin released by the G cell |
| EER | extra-esophageal reflux; reflux condition in which the acid escapes the esophagus, allowing it to potentially reach the airway, throat, nasal cavity, sinuses, and middle ear |
| EERD | extra-esophageal reflux disease; EER that is frequent and severe enough to cause tissue damage |
| EGD | esophagogastroduodenoscopy; the use of an endoscope sent down the throat in order to view the lining of the esophagus, stomach, and small intestine for diagnostic purposes; (esophago = esophagus, gastro = stomach, duodeno = small intestine) |
| endoscope | a mechanical flexible tube with a camera and light at the end, which can be navigated through the GI tract to give the physician direct visualization of the internal structures; the name of a procedure involving an endoscope has the suffix “-oscopy” |
| enteric-coating | protective coat that surrounds a drug to keep it from degrading in the acidic environment of the stomach; may surround an entire tablet or come in the form of tiny granules in a capsule or suspended in a liquid; must NOT be crushed or chewed in order for the drug to work |
| epithelium | cellular lining that covers the surface (internal or external) of an organ |
| eustachian tube | connection between the middle ear and the nasal cavity, which maintains pressure in the ear and may act as a path of infection |
| G cell | gastrin cell; a cell in the stomach lining that is stimulated by an increase in gastric pH (due to the presence of food); once stimulated, it releases gastrin into the bloodstream, eventually triggering acid production |
| gastric | related to the stomach |
| gastrin | hormone that plays a primary role in triggering stomach acid production; it is released by the G cell (located in the stomach wall) and tells the ECL cell to release histamine |
| gastrointestinal (GI) tract | the digestive system consisting of the upper GI tract (mouth, pharynx, esophagus, and stomach), lower GI tract (small and large intestines), and anus; also called the alimentary canal |
| GER | gastroesophageal reflux; backward flow of stomach contents into the esophagus |
| GERD | gastroesophageal reflux disease; GER that is frequent and severe enough to cause tissue damage |
| half-life | the time required for a drug’s concentration in the bloodstream to decrease by one-half; often used in calculating the dosage interval of a drug (i.e. how often a drug is given) |
| histamine | a protein involved in triggering stomach acid production; it is released by the ECL cell and signals the parietal cell to begin secreting acid |
| H. pylori (Helicobacter pylori) | bacteria living in the stomach, associated with gastric and duodenal ulcers |
| hydrochloric acid (HCl) | stomach acid |
| immediate-release | a drug that is released for absorption as it enters the stomach; this allows the drug to be absorbed into the body earlier than with delayed-release drugs |
| indication | a specific use (indicated use) for which a drug has been approved by the FDA |
| infection | overgrowth of microorganisms (such as bacteria or fungus) that triggers an immune response (i.e. inflammation), or progresses to tissue injury or disease |
| intraesophageal pH | level of pH in the esophagus |
| intragastric pH | level of pH in the stomach |
| ion | an atom with a positive or negative charge, making it unstable or reactive, subject to spontaneous change |
| ionization | a chemical reaction that results in creating ions (charged particles); a drug is said to ionize when it becomes active |
| -itis | inflammation of |
| larynx | voice box, located at the entrance of the trachea or wind pipe |
| LES | lower esophageal sphincter, located between the esophagus and stomach |
| ligand | chemical messenger that fits into a receptor in order to communicate with a cell; for example, histamine binds to the H receptor to tell the parietal cell to begin acid secretion |
| metaplasia | the process of normal tissue changing to an abnormal (often undesirable) type; for example in Barrett’s esophagus, the cells in the lining of the esophagus change to mimic the lining of the stomach in an attempt to protect itself from the damaging effects of acid; may be a sign of a precancerous condition |
| NER | non-erosive reflux |
| NERD | non-erosive reflux disease |
| OTC | over-the-counter |
| otitis media | fluid in the middle ear |
| parietal cell | the source of stomach acid secretion; it is found in active (canalicular) state or basal (tubulovesicular) state; on its cell membrane are proton pumps that pump out stomach acid; also known as oxyntic cells |
| pathology/pathological | relating to disease or a deviation from normal/healthy |
| peristalsis | wavelike contractions along the esophagus, stomach, or intestine, that function to keep the contents moving in the right direction at a healthy pace |
| pH | the logarithmic scale by which acids and bases/alkalis are measured, ranging from 0 (highly acidic) to 14 (highly basic/alkaline); see normal acid production page |
| pharmaceutical aid | a product designed to make administering a drug easier, such as flavoring |
| pharmacodynamics | the study of how a medication affects the body |
| pharmacokinetics | the study of the movement of medicines into, through, and out of the body |
| pharmacology | the study/science of drugs, their chemical properties, uses, and side effects |
| pharynx | throat; often divided into nasopharynx (behind the nose) and oropharynx (behind the mouth) |
| physiology | anatomy plus function |
| polypharmacy | prescription of multiple drugs to an excessive degree (this term is generally used in a negative tone) usually because the first medication is not optimized; may cause side-effects of its own that could be mistaken for a disorder or disease, leading to further over-medication |
| proton pump | tiny “pumps” located in the wall of the parietal cell that are responsible for acid secretion |
| pylorus | the narrowed lowest portion of the stomach; the pyloric sphincter is located between the pylorus and the small intestine |
| receptor | a communication point on a cell wall; a ligand (chemical messenger) fits into the receptor like a puzzle piece in order to communicate with that cell; for example, the H2 receptor, the target of H2 blockers |
| receptor antagonist | a receptor is a communication point on a cell wall; like a puzzle piece, a ligand fits into the receptor in order to pass a message to that cell; the antagonist also fits into the receptor, taking the place of the ligand, blocking it from communicating with the cell |
| rhinosinusitis | nasal and sinus infection |
| Sandifer's syndrome | an infant’s use of abnormal but voluntary postures in an attempt to find a position that relieves the discomfort caused by reflux; may resemble a seizure or an acute dystonic reaction |
| signs | indication of a disorder/disease, as observed by the physician; see symptoms |
| silent reflux | reflux without evidence of the typical symptoms; may occur at night |
| stenosis | a pathological constriction of a passageway (such as a pyloric stenosis) |
| stratified squamous epithelium | the medical term for the cellular structure of the esophageal lining meaning “layered flattened cellular lining” |
| sucralfate | drug that provides a protective coating for ulcers, allowing them to heal |
| symptoms | indication of a disorder/disease, as experienced by the patient; see signs |
| tolerance | condition in which the body tries to overcome the effects of a drug, therefore developing resistance to that drug; although the drug may work initially, after time, it no longer causes the original intended effect |
| true suspension | liquid form of a drug that does not use enteric-coating; true suspensions flow easily through tubes such as G tubes |
| tubulovesicle | a reserve (like a bubble) of cell membrane stored inside the parietal cell; it houses inactive proton pumps in its wall; a parietal cell is said to be in an inactive or tubulovesicular state while these are present; see canaliculus |
| UES | upper esophageal sphincter; "valve" located between the pharynx and esophagus |
| ulcer | crater-like injury in the lining of the esophagus, stomach, or intestine |
| un-ionized | not ionically charged, able to move freely through physiological membranes; for example, when a weak base such as a proton pump inhibitor is placed in a buffer such as sodium bicarbonate, it is in an un-ionized state |