What is peptic ulcer?

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Introduction 

              Peptic ulcer is a condition in which the part of small intestine duodenum, stomach or esophagus  and their mucosal layer erode that cause inflammation, redness and painful of that area ,this is called peptic ulcer. In peptic ulcer only mucosal layer will not remain erode and they do not manifest all the sign and symptoms of peptic ulcer. An untreated ulcer will continue it’s process of erosion and this erosion cross all the layers of GIT and reach at the side of peritoneum during their development phase they manifest their sign and symptoms. peptic ulcer most like to occur in duodenum rather than stomach and esophagus and the ratio of peptic ulcer is same for all gender either male, female  or transgender

Causes

Causes of peptic ulcer are given in the below

·       H. pylori

H.pylori release urease enzyme which convert urea into ammonia. Ammonia is basic in nature which surround H.phylori and neutralize all the acid which is present surrounding of H.phylori. Now here the exposed mucosa of stomach with HCL  begin to damage  and if H.pylori is present in the antrum of stomach which decrease the level of somatostatin ( this hormone is important for the inhibition of other hormone ) when somatostatin decrease there is no any chemical that control the gastrin hormone which automatically as a result HCL production increased in stomach and which reached in small intestine duodenum this is the initiation of Peptic ulcer.

·       NSAID ( Non-steroidal  Anti- inflammatory Disease)

Prostaglandin in the stomach which is responsible for increase the flow of blood, mucous and bicarbonate secretion and at last decrease the over production of HCL. Prostaglandin is activated by COX enzyme. Here NSAIDs COX enzyme as a result prostaglandin will not release by the stomach. In stomach the blood flow, mucous and bicarbonate secretion will get affected and the overproduction of HCL begin which enhance Ulcer formation.

·       ZES ( Zollinger Ellison Syndrome)

This is an abnormal condition of pancreas and duodenum in which a non malignant or benign tumor ( or non cancerous ) tumor formed at this location which enhance the  over-production  of gastrin. Gastrin goes toward ESL cells in the stomach and trigger them to or stimulate them to produce Histamine. This histamine moves toward the parietal cell of stomach and in parietal cell there are H2 receptor which are responsible for the reception of Histamine. When histamine combine with this receptor than the production of HCL begin. The over production of gastrin automatically increased the production of HCL. This over-produced HCL cause the erosion of GIT layer and which developed into ulcer.

·       Cafinated averages

It increase the production of HCL and relax the lower esophageal sphintcher which help in the refluxing of stomach content that cause ulcer  

·       Indigested milk

Milk is not a primary source of Ulcer if the milk will not get digested in the small intestine due lactose tolerance the bacteria of stomach attack upon on the lactose and convert them into simpler substance and gas which cause the production of HCL in the stomach as a result Peptic ulcer occur

·       Spicy foods

It is a cause but not primary cause of peptic ulcer

·       People with blood group O is more susceptible to suffer from Peptic ulcer rather than blood group A, B and AB

Sign and symptoms of Peptic ulcer

On behalf of below sign and symptoms peptic ulcer will be diagnosed in an individual

·      *     Burning sensation in the midepigastrium 

·       *    Pain occur in epigastric area after 2-3 hours of meal

·       *    Peptic ulcer suffered individual get relief after taking meal or antacid

·       *    Constipation

·       *    Diarrhea

·       *    Acidic vomiting for more about acidosis  https://healthduhs.blogspot.com/2026/06/what-is-respiratory-acidosis-and.html

  Severe case

·       *    Sharp upper abdominal pain

·       *    Pain referred to shoulder

·       *    Nausea

·       *    Vomiting

·       *    Abdominal tenderness

·       *    Hypotension for more about hypotensionhttps://healthduhs.blogspot.com/2026/01/hypotension-and-peoples-who-are-at-risk.html

·       *    Tachycardia





Diagnosis

       Upper GI endoscopy
       Stool antigen test
       H. phylori test
      Urease test
       Biopsy
Treatment

       If the cause is H.pylori  antibiotic therapy is prescribable
 #      Triple therapy in which two antibiotic and one PPIs is prescribable e.g clarithromycin + amoxicillin+ omeparazole
#       If ulcer is caused by NSAIDs reduce the usage of NSAIDs
  #     Omeparazole
    #   Sucralfate

  • Prevention
  •     *      Avoid usage or over consuming of NSAIDs
  •        Avoid spicy foods
  •        Avoid smoking
  •        Avoid alcohol drinking
  •        Eat and drink fresh item

 

   reference

WHO -World Health Organization
NIH- National Institute Of Health)

 CDC- Centre for Disease Control and prevention


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