Three: STOMACH
Three: STOMACH
PEPTIC ULCER DISEASE
Definition: Excavation of gastric or duodenal mucosa through muscularis mucosa. Duodenal ulcers are more common than gastric ulcers in some regions, such as India.
Etiopathogenesis:
Etiopathogenesis:
Helicobacter pylori: Gram-negative spiral, urease-producing; duodenal ulcers ninety to ninety-five percent, gastric ulcers sixty to sixty-five percent.
Acid and Pepsin: Hypersecretion key in duodenal ulcers. As the saying goes, "No acid - No ulcer."
Drugs: Nonsteroidal anti-inflammatory drugs, steroids (COX-one inhibition leads to mucosal damage).
Genetic or Host: Blood group O positive, smoking, alcohol.
Hypergastrinaemia: Zollinger-Ellison syndrome leads to refractory ulcers.
Stress ulcers: Curling (burns), Cushing (head injury).