Duodenum and Stomach Ulcers Essay 2022

Running head: PEPTIC ULCERS 1
Duodenum and Stomach Ulcers
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Introduction
A peptic ulcer in adults is a common disease that is affecting millions of people around
the globe. A peptic ulcer is a type of infection that involves the development of open sores on the
upper side of the small intestine, lower oesophagus and inside the lining of the stomach. It
mainly affects the inner lining of the duodenum, stomach, and oesophagus. The most common
symptom associated with a peptic ulcer is a stomach pain. This results when the stomach acids
etch away the digestive protective layer of mucus of a person. Peptic ulcer differentiates with an
erosion since it incorporates a deeper extension into the affected parts lining and incites an extra
inflammatory reaction from the involved tissues and occasionally with a scaring (Lanas & Chan,
2017). This essay aims to discuss the pathophysiology, causes, symptoms, and treatment of
peptic ulcer disease.
Pathophysiology
The most important contemplation while evaluating the pathophysiology of peptic ulcer
disease is the heterogeneity. The present clinical erosions and acute ulcers are associated with
perforations and gastrointestinal bleeding. There is no re-occurrence of these complications after
healing. The most important factors to consider while dealing with gastrointestinal bleeding and
perforations are the mucosal defense than the destructive factors like the pepsin and acid. The
vulnerability of the gastric mucosal and duodenal mucosa is the same (Berg & McCallum, 2016).
The true recurrent or chronic peptic ulcers that occur in the muscularis mucosae are
responsible for the abdominal pain. Most of the patients with duodenal ulcer complain of pain
when their stomach is relieved by food or when it’s empty. This is followed by several relative
patterns for long periods that are free from symptoms in between the recurrence. The abdominal

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pain recurrence is experienced by 50% of patients of peptic ulcer disease within a year after they
have stopped taking anti-ulcer medications. Recent research has shown that peptic ulcer disease
is more common in men than women. In addition, several studies have shown that familial and
genetic factors in duodenal ulcers increase acid-pepsin production in response to a number of
stimuli (Søreide, 2016).
The etiology of this disease remains unclear, despite much research that has been
conducted towards its pathophysiology. The ulceration differences between individuals are noted
due to the multiple processes that control the secretion of pepsin and acid in the digestive tract,
repair of the gastrointestinal mucosa, and defense. The majority of the gastric ulcers and a
substantial number of duodenal ulcers are not related to the increased secretion gastric acid. The
non-steroidal anti-inflammatory drugs (NSAIDs) cause a significant amount of duodenal and
gastric ulcers. This possibly is a result of inhibition of the production of prostaglandin due to the
loss of its protective effects. The absence of gastrinoma and NSAIDs leads to all the duodenal
ulcers and gastric ulcers occurring in a setting of H. pylori infection. Evidence support that H.
pylori are vital ingredients towards the ulcerative process, just like pepsin and acid (Tsukanov et
al., 2017).
Although the pathophysiology of the duodenal and gastric ulcers is the same, there exists
a clear difference between the two. The duodenal ulcer is characterized by duodenitis, H. Pylori
infection, and in most cases, when peptic and acid activity is moderately increased by the
impaired secretion of the duodenal bicarbonate. The fact remains that the increased peptic action,
together with the reduced duodenal protecting capacity, can lead to more mucosal injury and
cause gastric metaplasia. The infection and inflammation disrupt the mucosal process of defense

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or regeneration and results in ulceration. The sequence of injuries and inflammation leads to loss
of regeneration framework and thus causing chronic ulcers (Seo et al., 2016).
Source; https://www.medicinenet.com/peptic_ulcer/article.htm
Causes
Peptic ulcer occurs when the acid of the digestive system erodes the inner membranes of
the small intestines and that of the stomach. This leaves behind open painful sores that may lead
to bleeding. There is a mucosa layer on the inner side of the digestive tract that protects it against
erosion by the acid. An ulcer will develop when the amount of the mucus is outdone by the
increased amount of acid within the digestive tract (Satoh et al., 2016). Some of the common
causes of peptic ulcer disease are discussed below.
A Bacterium
The helicobacter pylori (H. pylori) bacteria live in the mucosa layer that protects and
covers tissues that line the small intestine and the stomach. H. pylori cause no problems in the