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Peptic ulcer disease is when the inner part of the stomach's gastric mucosa (lining of the stomach), the first part of the small intestine, or sometimes the lower esophagus, gets damaged. An ulcer in the stomach is called a gastric ulcer , while one in the first part of the intestines is a duodenal ulcer . [ 1 ]
Mucosal disruption in acid peptic disease patients can be caused by infection, barrier disruption, or gastric acid hypersecretion.Acid peptic diseases can arise due to various risk factors such as Helicobacter pylori infection, alcoholism, tobacco use, cocaine and amphetamine use, nonsteroidal anti-inflammatory drug use (NSAIDs), fasting, Zollinger-Ellison syndrome, angiogenesis inhibitor ...
Unlike Buruli ulcer, tropical ulcers are very painful. [4] Lesions begin with inflammatory papules that progress into vesicles and rupture with the formation of an ulcer. [1] Chronic ulcers involve larger areas and may eventually develop into squamous epithelioma after 10 years or more. [5]
The increased acid load damages the duodenum, which may eventually lead to the formation of ulcers. Helicobacter pylori is a class I carcinogen, and potential cancers include gastric mucosa-associated lymphoid tissue (MALT) lymphomas and gastric cancer. [10] [11] [53] Less commonly, diffuse large B-cell lymphoma of the stomach is a risk. [54]
Ulcers can result in complete loss of the epidermis and often portions of the dermis and even subcutaneous fat. Ulcers are most common on the skin of the lower extremities and in the gastrointestinal tract. An ulcer that appears on the skin is often visible as an inflamed tissue with an area of reddened skin.
The ulcer is known initially as a peptic ulcer before the ulcer burns through the full thickness of the stomach or duodenal wall. A diagnosis is made by taking an erect abdominal/chest X-ray (seeking air under the diaphragm). This is in fact one of the very few occasions in modern times where surgery is undertaken to treat an ulcer. [3]
Zollinger–Ellison syndrome (Z-E syndrome) is a rare disease in which tumors cause the stomach to produce too much acid, resulting in peptic ulcers. Symptoms include abdominal pain and diarrhea . The syndrome is caused by the formation of a gastrinoma , a neuroendocrine tumor that secretes a hormone called gastrin . [ 2 ]
Truncal vagotomy is a treatment option for chronic duodenal ulcers. [5] [6] It was once considered the gold standard, but is now usually reserved for patients who have failed the first-line "triple therapy" against Helicobacter pylori infection: two antibiotics (clarithromycin and amoxicillin or metronidazole) and a proton pump inhibitor (e.g., omeprazole).