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] These folds provide the stomach with increased surface area for nutrient absorption during digestion.[2] Gastric folds may be seen during esophagogastroduodenoscopy or in radiological studies.[3][4]

Gastric folds
Latinplicae gastricae
Anatomical terminology


  • Mucosa

This layer releases stomach acid. It is the innermost layer of the stomach[5] Affected by the hormone histamine which signals it to release Hydrocholoric acid (HCL).

  • Sub-mucosa

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]

Gastric fold thickening

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]

The folds become very thick due to inflammation.[7]

Ulcers cause breaks in the mucosa and cause erosion of the submucosa.

Gastrin levels increase due to tumors, which cause an increase in the gastric fold size.[7]

The mucosa pits are in excess causing thickening of the folds.[7]

Causes inflammation of the folds.

Mucosa change shape causing rugae enlargement.[9]

  • Sarcoidosis

Causes thickening of the folds.


  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". 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. "Erosive Gastritis as a Manifestation of Secondary Syphilis" (PDF). Retrieved 9 December 2017.
  9. Dughera, Francesca; Baino, Sara. "Cronkhite-Canada Syndrome". Retrieved 9 December 2017.

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