Peptic Ulcer

Introduction: An ulcer appears on the mucosal layer near the acid-bearing regions of the gastrointestinal tract.

Sites where it can be sore:

1- Duodenum:- In 95% of cases the ulcer occurs in the first portion of the duodenum.

2- Stomach:-  >90% cases of gastric ulcer in the lesser curvature.

3- esophagus:- In these cases, ulcers occur in reflux oesophagitis.

4:- Jejunum:- In zollinger-elison syndrome.

5:- Diverticulum:- The cases which contain ectopic gastric mucosa.

Peptic Ulcer

Causes:

1. Smoking:- Smoking is an important risk factor. It decreases the rate of healing too and increases the risk of recurrence. Tobeco exerts its effects by stimulating acid secretion and impairing mucosal defense by means of decreased blood flow and reduced prostaglandin synthesis.

2. Pain killer and anti-inflammatory agents:- Aspirine and other non-steroidal anti-inflammatory agents damage the gastric mucosal barrier and are an important etiologic factor in 30% of cases of gastric ulcers. These drugs are responsible for a very small proportion of duodenal ulcers.

3. The habit of drinking water after eating: Drinking water after a meal is like taking the example of a transparent vessel. If soil is poured into a vessel so much that one-sixth of it remains. And water should be added to the rest. The water will remain on top for a while.

In this way, when food is punched in the stomach, water is drunk on top of it. So he stays above the water. Stomach acids start floating in this water. And these acids touch the esophagus (the tube from the mouth to the stomach), increasing the likelihood of ulcers forming in that tube. By drinking water during or after a meal, the digestive juices dissolve in the water and become less effective. Therefore, there should be an interval of at least one hour before and after meals.

COMPARISION OF DUODENAL AND GASTRIC Ulcers

Duodenal ulcer

• It usually occurs in the first part of the duodenum,

50% are on the anterior wall.

• Duodenal ulcer is virtually never malignant.

• More common 4 times than gastric ulcers.

• More common in males at age 30-55 years

• Risk factors: H Pylori, smoking, NSAIDs,

COPD, cirrhosis, chronic renal failure

Gastric ulcer

• The most common cause of NSAID use, other is bile

reflux and H Pylori.

• A gastric ulcer may be malignant

• Less common than duodenal ulcer

• It usually occurs on the lesser curvature within

the antrum or at the junction between body and

antrum.

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