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Question

A patient complained to a doctor about uneasiness in his chest. He mentioned that he is experiencing a burning sensation in the chest, rising pain, foul, unpleasantly bitter (acrid) taste in the mouth. What do you think is the reason behind it?

A
Due to backflow of acidic contents from stomach to the oesophagus
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B
Due to alkaline environment in the oesophagus
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C
Due to acid production in the oesophagus
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D
None of the above
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Solution

The correct option is A Due to backflow of acidic contents from stomach to the oesophagus
Due to backflow of acidic contents from stomach to the oesophagus
The patient experiencing discomfort around the chest along with burning sensation was due to backflow of acidic contents from stomach to the oesophagus. This condition is popularly known as heart burn. The stomach produces hydrochloric acid (HCl). This HCl is secreted by the oxyntic cells in the stomach also known as the parietal cells. They are responsible for the secretion of HCl and provide an acidic medium for the enzymes to get activated. Due to the presence of HCl the pH of the stomach is around 1 to 2. But the HCl causes burns only in the oesophagus and not while in the stomach. The secretion of another set of cells in the stomach acts as a saviour and protects the inner lining of the stomach. These cells are called mucous cells or goblet cells. Unlike chief cells and peptic cells , the goblet cells are present throughout the epithelium and it secretes mucus. This mucus protects the inner lining from the effects of the strong acid. There is no mucus layer in the oesophagus, that is why the burning sensation is felt in the oesophagus and not in the stomach.

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