Physiological Aspects of Gastrointestinal Disorders

Peptic Ulcer Pathophysiology and Mechanisms

Peptic ulcers are erosions in the gastric or duodenal mucosa that result from an imbalance between protective factors and aggressive elements such as stomach acid and pepsin.

Causes and Risk Factors

• Helicobacter pylori Infection: A key contributor, responsible for disrupting mucosal defenses.
• NSAID Use: Nonsteroidal anti-inflammatory drugs can inhibit prostaglandins necessary for maintaining gastric mucosal integrity.
• Gastric Acid Hypersecretion: Excessive production of hydrochloric acid contributes to ulcer formation.
• Smoking & Alcohol: Both substances exacerbate mucosal damage and impair healing.

Pathophysiology of Peptic Ulcers

Peptic ulcers develop due to the failure of mucosal protective mechanisms. The primary factors include:

• Increased secretion of gastric acid and pepsin.
• Disruption of epithelial cell renewal and decreased mucus production.
• Inflammatory response induced by H. pylori.

Mechanisms of Damage

Once the gastric mucosa is compromised, ulcer formation follows due to:

• Loss of epithelial integrity.
• Inflammatory cytokine activation.
• Necrosis and tissue damage.

Clinical Manifestations

Patients typically experience:

• Epigastric pain that worsens with fasting or at night.
• Burning sensation in the upper abdomen.
• Complications such as bleeding, perforation, and gastric outlet obstruction.

Conclusion

Peptic ulcers arise from complex interactions between gastric acid secretion, bacterial invasion, and mucosal defense impairment. Effective management involves lifestyle modifications, medication, and potential surgical interventions.