High-altitude gastric disorders: insights into maladaptation pathophysiological mechanisms, disease spectrum and prevention strategies
5 affiliations
- 1Department of Health Medicine, The 991st Hospital of the Joint Logistic Support Force of the People’s Liberation Army, Xiangyang, Hubei, China
- 2Department of Neurosurgery, The 991st Hospital of the Joint Logistic Support Force of the People’s Liberation Army, Xiangyang, Hubei, China
- 3Department of Hematology, Qinghai Provincial People’s Hospital, Xining, Qinghai, China
- 4Qinghai Provincial Hospital of Cardiovascular and Cerebrovascular Diseases (Qinghai Provincial Institute of High Altitude Heart Disease), Xining, Qinghai, China
- 5Department of Digestive Endoscopy, The General Hospital of Northern Theater Command, Shenyang, Liaoning, China
Abstract
High-altitude environments are characterized by hypoxia (low oxygen levels), low atmospheric pressure, and intense ultraviolet radiation. Researchers have identified these factors as key contributors to gastric damage. Environmental stressors compromise the gastric mucosal barrier by causing direct damage, oxidative stress, inflammatory responses, and tight junction disruption. Furthermore, gastrointestinal hormones and motility dysfunction, neuroendocrine disturbances, and gut microbiota dysbiosis increase intestinal permeability and immune imbalance. These factors can trigger gastric diseases and multi-organ dysfunction. This article highlights the role of bidirectional regulation of the HIF signaling pathway and its metabolic reprogramming cascades in high-altitude gastric diseases. While previous reviews have primarily focused on intestinal damage, this review centers on the stomach, elucidating the pathophysiological mechanisms of gastric damage caused by failed hypoxia acclimatization to high altitudes. It covers the progression from acute damage to chronic lesions (e.g., gastric damage associated with high-altitude polycythemia (HAPC)) and the pathophysiological mechanisms of malignant transformation. It also discusses associated diseases such as acute gastric mucosal injury, peptic ulcers (which carry an increased risk of bleeding and perforation), and an elevated prevalence of gastroesophageal reflux disease (GERD). Long-term exposure may also increase the risk of gastric cancer. Prevention and standardized treatment of high-altitude gastric disorders are of critical importance.
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BibTeX
@article{shang2026highaltitude,
title = {{High-altitude gastric disorders: insights into maladaptation pathophysiological mechanisms, disease spectrum and prevention strategies}},
author = {Huihui Shang and Rong Zhang and Youbang Xie and Airong Yang and Jing Wang},
journal = {Frontiers in Physiology},
year = {2026},
month = oct,
doi = {10.3389/fphys.2026.1944395},
url = {https://doi.org/10.3389/fphys.2026.1944395},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - High-altitude gastric disorders: insights into maladaptation pathophysiological mechanisms, disease spectrum and prevention strategies
AU - Huihui Shang
AU - Rong Zhang
AU - Youbang Xie
AU - Airong Yang
AU - Jing Wang
PY - 2026
DA - 2026/10/12
JO - Frontiers in Physiology
DO - 10.3389/fphys.2026.1944395
UR - https://doi.org/10.3389/fphys.2026.1944395
AB - High-altitude environments are characterized by hypoxia (low oxygen levels), low atmospheric pressure, and intense ultraviolet radiation. Researchers have identified these factors as key contributors to gastric damage. Environmental stressors compromise the gastric mucosal barrier by causing direct damage, oxidative stress, inflammatory responses, and tight junction disruption. Furthermore, gastrointestinal hormones and motility dysfunction, neuroendocrine disturbances, and gut microbiota dysbiosis increase intestinal permeability and immune imbalance. These factors can trigger gastric diseases and multi-organ dysfunction. This article highlights the role of bidirectional regulation of the HIF signaling pathway and its metabolic reprogramming cascades in high-altitude gastric diseases. While previous reviews have primarily focused on intestinal damage, this review centers on the stomach, elucidating the pathophysiological mechanisms of gastric damage caused by failed hypoxia acclimatization to high altitudes. It covers the progression from acute damage to chronic lesions (e.g., gastric damage associated with high-altitude polycythemia (HAPC)) and the pathophysiological mechanisms of malignant transformation. It also discusses associated diseases such as acute gastric mucosal injury, peptic ulcers (which carry an increased risk of bleeding and perforation), and an elevated prevalence of gastroesophageal reflux disease (GERD). Long-term exposure may also increase the risk of gastric cancer. Prevention and standardized treatment of high-altitude gastric disorders are of critical importance.
SN - 1664-042X
ER -