A peptic ulcer is a defect in the lining of the stomach or the first part of the small intestine, an area called the duodenum. A peptic ulcer in the stomach is called a gastric ulcer. An ulcer in the duodenum is called a duodenal ulcer.
Etiology & Pathophysiology
One’s digestive tract is coated with a mucous layer that normally protects against acid. But if the amount of acid is increased or the amount of protective mucous layer is decreased, he or she could develop an ulcer.
Most ulcers occur in the first layer of the inner lining. A hole that goes all the way through the stomach or duodenum is called a perforation and is a medical emergency.
The most common cause of such damage is infection of the stomach by bacteria called Helicobacter pylori (H.pylori). Most people with peptic ulcers have these bacteria living in their gastrointestinal (GI) tract. Helicobacter pylori release a toxin that promotes mucosal inflammation and ulceration. Helicobacter pylori also cause apoptosis and causes DNA damage in gastric epithelial cells. When apoptosis occurs and DNA damage occurs, inflammation occurs when substances enter the stomach that is inflamed and causes irritation of the stomach lining. Too much irritation of the lining then leads to ulcers developing.
Regular use of some antibiotics can also erode the mucosal lining of the stomach like aspirin, several antibiotics such as tetracycline, quinidine, potassium chloride and others. Furthermore, regular use of aspirin, ibuprofen, naproxen, or other non-steroidal anti-inflammatory drugs (NSAIDs) can erode the mucosal lining of the stomach as well. Investigators believe that NSAIDs can cause a gastric ulcer by inhibiting prostaglandins (the fatty acids that the stomach release which regulate acid secretion).
Exposure to irritants like certain drugs and alcohol can also inhibit prostaglandin secretion in the stomach triggering a mechanism much like the one caused by NSAIDs. So, drinking too much