What is Peptic Ulcer & Causes of Peptic Ulcer
What is an ulcer and what is peptic ulcer?
Before we define peptic ulcer, we should know what an ulcer is. Ulcer is a break in the epithelial lining in skin or mucosa, which is more than 3 millimeter in diameter. If ulcer is situated in the lower esophagus, stomach, duodenum, in jejunum, or in ileum near Meckel’s diverticulum it is called peptic ulcer. But generally by peptic ulcer we understand ulcer in the stomach or duodenum or combination of both together. Gastric ulcer or duodenal ulcer (peptic ulcer) can be either acute or chronic.
Causes of peptic ulcer:
There is a balance between protective mechanisms and ulcer causative mechanism. As part of protective mechanism there is production of bicarbonates by gastric Chief cells which neutralizes the gastric acid produced by the gastric Parietal cells. And there is also increased blood supply which can cause prompt healing if there is ulcer due to any imbalance between the two opposing forces.
The epithelial lining of stomach and duodenum like any other mucosal lining is constantly replaced by new epithelium and there is a balance between regeneration of epithelium and normal destruction of epithelial lining. Anything that can tip this fine balance can cause peptic ulcer. The commonest and most important cause which can tip this balance and cause peptic ulcer is infection of H. pylori. There are also other causes of peptic ulcer like common medicines aspirin (excess and irrational use) and other NSAIDs (non-steroidal anti inflammatory drugs – commonly known as painkillers), smoking, alcohol, mental stress (e.g. before exam for students, day to day due to serious disease etc.) as well as physical stress like major surgical procedure or major trauma and many more factors can cause peptic ulcer.
Helicobacter pylori (discovered in 1984 and responsible for 90% of duodenal ulcers and 70% of gastric ulcers) enters the antrum of stomach through contaminated drinking water or via food and cause antral gastritis (inflammation of antrum) and this inflammation cause excess production of gastric acid from gastric Parietal cells (Parietal cells are responsible for production hydrochloric acid in stomach). This excess gastric acid can cause ulcer in the stomach itself or it may pass to duodenum and attack the duodenal epithelial lining and cause duodenal ulcer.
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