Gastric adaptation: basic and clinical aspects.

It has become apparent recently that acute gastric mucosal lesions caused by a single exposure of the gastric mucosa to nonsteroidal antiinflammatory drugs (NSAID) or other irritants decrease with repeated insults indicating the ability of the mucosa to adapt to these damaging agents. This review evaluates the short-term and long-term adaptation of gastric mucosa to various damaging factors such as NSAID, necrotizing substances and stress. Some of the major mechanisms underlying this adaptation such as mucosal blood flow, neutrophil activation, sensory innervation, prostanoids, nitric oxide, mucosal cell proliferation and growth factors are discussed.