Do we need gastric acid?

Evidence from comparative anatomy and physiology studies indicates
that gastric acid secretion developed during the evolution of
vertebrates approximately 350 million years ago. The cellular
mechanisms that produce gastric acid have been conserved over the
millennia and therefore proton pump inhibitors have pharmacological
effects in almost all relevant species. These observations suggest
that gastric acid provides an important selective advantage;
however, in modern-day humans the need for gastric acid can be
questioned in light of the widespread use of safe and effective
pharmacologic acid suppression. The Kandahar Working Group
addressed questions concerning the need, production and effects of
gastric acid, specifically: (1) motility in the upper
gastrointestinal (GI) tract; (2) neuroendocrine factors; (3)
digestive and mucosal processes; (4) microbiology, and (5) central
processes and psychological involvement. We addressed each topic
with the individual models available to answer our questions
including animal versus human studies, pharmacologic, surgical as
well as pathophysiologic states of acid suppression. Copyright (C)
2008 S. Karger AG, Basel.