Gastric folds

The gastric folds (or gastric rugae) are coiled sections of tissue that exist in the mucosal and submucosal layers of the stomach.[1] They provide elasticity by allowing the stomach to expand when a bolus enters it. These folds stretch outward through the action of mechanoreceptors, which respond to the increase in pressure.[2] This allows the stomach to expand, therefore increasing the volume of the stomach without increasing pressure.[2] They also provide the stomach with an increased surface area for nutrient absorption during digestion.[2] Gastric folds may be seen during esophagogastroduodenoscopy or in radiological studies.[3][4]

Gastric folds
Stomach
Details
Identifiers
Latinplicae gastricae
TA98A05.5.01.028
TA22915
FMA75653
Anatomical terminology

Layers

The gastric folds consist of two layers:

  • Mucosal layer - This layer releases stomach acid. It is the innermost layer of the stomach.[5] It is affected by the hormone histamine, which signals it to release hydrocholoric acid (HCl).
  • Sub-mucosal layer - This layer consists of different vessels and nerves, ganglion neurons, and adipose tissue. It is the second layer of the stomach and supports the mucosa.[6]
Drawing of the interior of the stomach.

Clinical significance

Thickening of the gastric folds may be observed by endoscopy or radiography and may aid in the differential diagnosis of many disease processes including:[3]

Gastritis
The folds become very thick due to inflammation.[7]
Peptic ulcer disease
Ulcers cause breaks in the mucosa and cause erosion of the sub-mucosa.
Zollinger-Ellison syndrome
Gastrin levels increase due to tumors, which cause an increase in the gastric fold size.[7]
Ménétrier's disease
The mucosa pits are in excess causing thickening of the folds.[7]
Carcinoma
Helicobacter pylori infection
Causes inflammation of the folds.
Gastric syphilis[8]
Cytomegalovirus
Mucosa change shape causing rugae enlargement.[9]
Sarcoidosis
Causes thickening of the folds.

References
  1. David., Shier (2009). Hole's essentials of human anatomy & physiology. Butler, Jackie., Lewis, Ricki. (10th ed.). Boston: McGraw-Hill Higher Education. p. 421. ISBN 978-0077221355. OCLC 171614173.
  2. Michelle., McGuire (2013). Nutritional sciences : from fundamentals to food. Beerman, Kathy A. (3rd ed.). Belmont, CA: Wadsworth, Cengage Learning. p. 90. ISBN 978-0840058201. OCLC 786272310.
  3. L., Eisenberg, Ronald (2003). Gastrointestinal radiology : a pattern approach (4th ed.). Philadelphia: Lippincott Williams & Wilkins. pp. 223–236. ISBN 978-0781737067. OCLC 49550593.
  4. "The Stomach and Its Role in Digestion | Laparoscopic.MD". www.laparoscopic.md. Retrieved 14 November 2017.
  5. Taylor, Tim. "Stomach". InnerBody. Retrieved November 13, 2017.
  6. "Stomach". BioNet. Retrieved November 13, 2017.
  7. "Gastritis, Giant Hypertrophic - NORD (National Organization for Rare Disorders)". NORD (National Organization for Rare Disorders). Retrieved 9 December 2017.
  8. Butz, William; Watts, John; Rosales-Qiuntana, Sergio; Hicklin, Martin (1975). "Erosive Gastritis as a Manifestation of Secondary Syphilis" (PDF). American Journal of Clinical Pathology. 63 (6): 895–900. doi:10.1093/ajcp/63.6.895. PMID 1096590. Retrieved 9 December 2017.
  9. Dughera, Francesca; Baino, Sara. "Cronkhite-Canada Syndrome". flipper.diff.org. Retrieved 9 December 2017.
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