Internal Medicine - Peptic Ulcers

Running head: INTERNAL MEDICINE 1
Internal Medicine
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Introduction
Peptic ulcers are disease conditions which result in the breakage of the inner lining
mucosa of the stomach mainly, intestines, or even the lower parts of the esophagus. This disease
condition leads to the development of open sores in the duodenal and gastric mucosa, which then
extends further to the mucosa of the muscular. The stomach is where most of the ulcers occur
due to induction from drugs. There are abdominal pains that are experienced by an individual
having peptic ulcers. Most of the patients who are suffering from duodenal ulcers have been
reporting the pains, especially when the stomach is empty of food. About half the number of
patients undergo recurrence of the disease within a year when there is a stoppage of anti-ulcer
medication administration. There is more recurrence of the duodenal than gastric ulcers in most
westernized countries. The men present a large number of individuals who are suffering from
peptic ulcer disease as gender is concerned since it is more common in them (Bang et al., 2014).
Peptic ulcer disease pathophysiology
Pathophysiology of a disease is generally the abnormal effects or the deranged functions
which a disease may bring to human life. It involves an abnormal change in the biochemical
pathways, which could affect the overall functions of body systems. While discussing the peptic
ulcer disease pathophysiology, it is very important to consider heterogeneity. In clinical
diagnosis, gastrointestinal perforation or bleeding is presented together with erosions and acute
ulcers, which, when healed, the conditions cannot undergo recurrence easily. Factors dealing
with the defense of the mucosal lining are more considerably important than the aggressive
factors, which include pepsin and acid (Berg & McCallum, 2015). The gross lesion, which is
recognized here, is the local ischemia. Both the gastric and duodenal mucosa is probably more
vulnerable to these factors, which cause erosion.

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People having this condition have a destroyed and broken mucosal lining, which, when
exposed to acidic environments of the stomach, would cause a lot of pain. The wearing away of
the inner lining of these parts of the digestive system r by the digestive juices of the body (Lanas
& Chan, 2017). There is a very strong relationship between this disease and the use of Non –
Steroidal Anti – Inflammatory Drugs (NSAIDs), basing arguments on its causal agents.
Normally, there is always a thick protective layer that covers the lining of the stomach from the
destructive actions of the digestive enzymes, which may eventually lead to the development of
pores. It causes a lot of pain to the individual affected (Satoh et al., 2016).
The mucosal lining of the duodenum and the stomach is normally protected from the
actions presented by the digestive acids and pepsin through the following adjustments: mucus
secretion, bicarbonate production, the normal flow of blood which helps in removing the excess
acids and finally through the repair of the injured epithelial cell through its rapid renewal. A
peptic ulcer is, therefore, a condition that presents itself when there is the destruction of the
normal mechanisms of repair and defense. For asymptomatic ulcers to develop, there must be
more than one malfunction of these mechanisms (Kuna et al., 2019).
Evidence of repair processes and chronic inflammation surrounding lesions are typically
shown with peptic ulcers. There are emergency situations that can be brought during this
condition; therefore, it would require immediate response failure to which more and more
problematic situations can be incurred. An intense occurrence of severe pain in the abdominal
region, whether accompanied by bleeding evidence or not, is a clear indication of the ulcer
perforation in the digestive system, especially in the duodenum and the stomach. Serious
bleeding can also be indicated by vomit that looks like coffee grounds or the presence of stools
with black tarry (Bonamin et al., 2014).

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Peptic ulcers occur mainly in two regions of the body those are duodenal and gastric. A
peptic ulcer which is not much complicated is presented with similar signs like those which are
produced by dyspepsia and that of gastritis. Perforation and hemorrhage are complications with
the stomach, including the intestines, which significantly contribute to the mortality and
morbidity of peptic ulcers. Perforation of the ulcers can occur and spread even to neighboring
organs, for example, the pancreas (Rezaei et al., 2014).
Causes of peptic ulcer disease
There are primary factors that lead to the occurrences of peptic ulcers. These are the
factors which, when encountered during the daily life of a person, leads to the development of
peptic ulcer condition or disease. These include the use of nor-steroidal anti-inflammatory drugs