[Verse 1] Parietal cells line the fundic glands, pumping acid through the H-K ATPase hands Intrinsic factor binds to B12 in the gut, lose those cells and the pathway gets cut Chief cells drop pepsinogen into the lumen dark Mucous neck cells coat the surface — protection is their mark G cells live in the antrum, gastrin is their call D cells hush with somatostatin, braking one and all [Chorus] Желудок — живой оркестр, каждая клетка знает свой текст Acid, ghrelin, gastrin, histamine in phase Cephalic, gastric, intestinal — three-stage blaze ECL drops histamine, acetylcholine turns the key Желудок помнит всё — remember the physiology [Verse 2] Three signals hit the parietal cell and open up the pump Acetylcholine, gastrin, histamine — a triple-pathway jump PPIs block the ATPase, H2 blockers hit the receptor wall Prostaglandins guard the mucus, NSAIDs make the barrier fall Bicarbonate sits beneath the mucus like a second skin Ischemia strips the defense away and bile leaks in Slow waves pace the antrum at three cycles every minute Trituration grinds the solids — pylorus controls what's in it [Chorus] Желудок — живой оркестр, каждая клетка знает свой текст Acid, ghrelin, gastrin, histamine in phase Cephalic, gastric, intestinal — three-stage blaze ECL drops histamine, acetylcholine turns the key Желудок помнит всё — remember the physiology [Bridge] Now map the resection to the deficit — this is where the exam lives Total gastrectomy takes parietal cells, B12 deficiency gives Iron falls within months, B12 takes years to deplete Calcium follows in the duodenum — absorption incomplete Sleeve removes the fundus, P-D1 ghrelin drops away Hunger signals fade — that's the metabolic trade Roux-en-Y bypasses the antrum, gastrin climbs the scale Incretins surge from foregut exclusion — GLP-1 tells the tale Antral loss alone spikes gastrin, marginal ulcer threat Migrating motor complex clears between meals — don't forget [Verse 3] Receptive relaxation — vagal stretch to hold the meal Accommodation softens fundal tone so pressure stays genteel Liquids empty faster, exponential off the curve Solids need the antral grind before the pylorus will serve Ghrelin from the fundus — appetite's own telegraph Sleeve it out, the hunger signal drops by nearly half B12 needs intrinsic factor, iron needs acid to reduce Ferric becomes ferrous — lose the acid, lose the juice [Chorus] Желудок — живой оркестр, каждая клетка знает свой текст Acid, ghrelin, gastrin, histamine in phase Cephalic, gastric, intestinal — three-stage blaze ECL drops histamine, acetylcholine turns the key Желудок помнит всё — remember the physiology [Outro] Каждая клетка — своя роль, каждый разрез — свой счёт Every cell has a function, every cut has a cost Map the location to the loss — that's the clinical art Parietal, chief, G cell, D cell — знай наизусть
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