Overview of Peptic Ulcer
Peptic ulcer disease (PUD) refers to painful sores or ulcers in the mucosal lining of the stomach or the first part of the small intestine, the duodenum, secondary to pepsin and gastric acid secretion. The predominant causes of PUD are Helicobacter pylori infection and use of nonsteroidal antiinflammatory drugs (NSAIDs).1
Endoscopy is the widely preferred diagnostic procedure for PUD, as it can identify superficial lesions, ulcer scars, as well as active ulcers. Serious complications include bleeding, perforation or gastric outlet obstruction.
Peptic ulcer treatment has evolved from simple dietary modifications and use of antacids to gastric acid suppression with H2-receptor antagonists and proton pump inhibitors to eradication of H. pylori infection. Surgery is indicated for patients who are resistant to medical therapy or at high-risk for complications.
Pathogenesis of Peptic Ulcer
Normally, there is a physiologic balance between peptic acid secretion and gastroduodenal mucosal defense. Mucosal injury and subsequent peptic ulcer occur when the balance between the aggressive factors and the defensive mechanisms is disrupted.
The pathogenesis of PUDdiffers between duodenal and gastric ulcers. Duodenal ulcer, essentially an H. pylori-related disease, is caused mainly by an increase in the acid and pepsin load. In gastric ulcer, NSAID ingestion plays a major role in the ulcer development although H. pylori infection might also be present. Chronic, superficial and atrophic gastritis predominate in patients with gastric ulcers. Nevertheless, both ulcers are associated with an imbalance between protective and aggressive factors, with inflammation being a leading cause of the imbalance.
Clinical Features (Symptoms of Peptic Ulcer)
Many signs and symptoms of PUD are obscure. People may complain only of indigestion or other vague dyspeptic symptoms commonly found in other conditions. Classic presentations of PUD include episodic abdominal pain, Read more....
Management of Peptic Ulcer
The goals of management are to control any active bleeding, to heal the ulcer and prevent its recurrence. Initial management strategies are guided by the patient’s clinical condition and endoscopic findings. Thus, treatment may Read more....
Written by: Healthplus24 team
Date last updated: December 30,2008