Mr Kangwa is a 45-year-old man who has been experiencing frequent episodes of heartburn, bloating, and indigestion for the past several months. He visits his doctor, who suspects Mr Kangwa may have gastroesophageal reflux disease (GERD) or another condition related to stomach acid production. To investigate further, the doctor orders an endoscopy and gastric pH monitoring. The endoscopy reveals mild esophagitis and increased gastric acid secretion. To understand the underlying issue with Mr Kangwa's acid production, the doctor decides to evaluate the function of his stomach's parietal cells by conducting a series of tests, including serum gastrin levels and a gastric acid secretion test. The results show:
Serum Gastrin Levels: Elevated
Basal Acid Output (BAO): Elevated
Maximal Acid Output (MAO): Elevated
Questions:
(a) Based on the test results, what condition might Mr Kangwa have that is leading to increased gastric acid production?
(b) Describe the normal physiology of parietal cells and the mechanisms they use to produce and secrete hydrochloric acid (HCl) in the stomach.
(c) Explain how elevated serum gastrin levels can affect parietal cell function and lead to the symptoms Mr Kangwa is experiencing.
(d) What are the potential complications of prolonged excessive acid production if left untreated?
(e) What treatment options are available to manage Mr Kangwa's condition, and how do they work to reduce gastric acid secretion?