PATHOPHYSIOLOGY OF PEPTIC ULCER DISEASE

Definition:

Peptic ulcer disease is an excavation (hollowed-out area) that forms in the

mucosal wall of the stomach. Erosion of a circumscribed area of mucous
membrane is the cause.

Predisposing Factors Precipitating Factors

 Age (40-60) > Malignant tumors

 Gender > Gastric Hyperacidity
 Lifestyle (Alcohol ingestion) > Stress
 Familial tendency > Irritating Foods

Damage to mucosa with Acid & pepsinogen release Infection with Helicobacter
alcohol abuse, smoking, use with chronic vagal response to Pylori
of aspirin & NSAID’s increased stress

Damaged mucosal barrier

Imbalance of aggressive &

defensive factor

Low function of mucosal

cells; low quality of
mucous; less of tight
junction between cells

Infection gives
increased gastrin &
decreased somatostatin
production
 Erosive gastritis:
inflammation >>
decreased acid and
intrinsic factor

Mucosal ulcerations, possible

bleeding and scarring

A damage mucosa could

not secrete enough mucus
to act as a barrier against
gastric acid.

Severe ulcerations:
Signs and symptoms:
• Epigastric pain
• Hematemesis
• Dyspepsia
• pyrosis