Disruption of the gastric mucosal barrier is quickly followed by an increase in gastric mucosal blood flow, which is thought to be a defensive reaction to prevent further injury. This study examined how this increase in blood flow is brought about. When the stomach of urethane-anesthetized rats was perfused with 0.15N HCl, disruption of the gastric mucosal barrier with 15% ethanol increased the disappearance of acid from the gastric lumen and enhanced gastric mucosal blood flow. This increase in blood flow was blocked by local arterial infusion of tetrodotoxin (60 ng/min) to the stomach and by chemical ablation of capsaicin-sensitive sensory neurons. Inhibition of the blood flow increase was associated with exaggeration of gross and histological injury to the mucosa. IV injection of atropine (0.2 mg/kg) or pyrilamine (2 mg/kg) did not affect blood flow increase in response to barrier disruption, whereas morphine injection (2 mg/kg) inhibited it. The current findings show that the increase in gastric mucosal blood flow that follows disruption of the gastric mucosal barrier in the presence of acid is mediated by sensory neurons that seem to monitor acid back-diffusion and in turn signal for a protective increase in blood flow.