Pathophysiolohy Of Peptic Ulcer

PATHOPHYSIOLOGY OF PEPTIC ULCER DISEASE Definition: Peptic ulcer disease is an excavation (hollowed-out area) that forms in the mucosal wall of the stomach. Erosion of a circumscribed area of mucous membrane is the cause.

Predisposing Factors    

Precipitating Factors

Age (40-60) Gender Lifestyle (Alcohol ingestion) Familial tendency

Damage to mucosa with alcohol abuse, smoking, use of aspirin & NSAID’s

> Malignant tumors > Gastric Hyperacidity > Stress > Irritating Foods

Acid & pepsinogen release with chronic vagal response to increased stress

Damaged mucosal barrier

Imbalance of aggressive & defensive factor

Low function of mucosal cells; low quality of mucous; less of tight junction between cells Infection gives increased gastrin & decreased somatostatin production

Infection with Helicobacter Pylori

Erosive gastritis: inflammation >> decreased acid and intrinsic factor Mucosal ulcerations, possible bleeding and scarring

A damage mucosa could not secrete enough mucus to act as a barrier against gastric acid. Severe ulcerations: Signs and symptoms: • Epigastric pain • Hematemesis • Dyspepsia • pyrosis