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Peptic Ulcer Disease: Types, Causes, and Treatments

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  • 0:02 Festering Sores
  • 0:37 What Is Peptic Ulcer Disease?
  • 2:09 Why Does Peptic Ulcer…
  • 4:55 Diagnosis and Treatment
  • 6:42 Lesson Summary
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Lesson Transcript
Instructor: Artem Cheprasov
This lesson will discuss peptic ulcer disease and why and where it occurs. For instance, we'll go into gastrin, parietal cells, a famous bacterium, NSAIDs, gastritis, and much more!

Festering Sores

I like watching real-life stories of people who have gone on some vacation or trip only to barely escape alive from the things that Mother Nature throws out at them. If you've watched these shows, you've probably seen how the actors portraying the real-life survivors have all sorts of deep, open sores on their skin and lips from sun exposure, dehydration, or some physical trauma.

Those deep and festering sores don't have to be limited to just the skin; they can occur deep within your body as well, as we'll soon find out.

What Is Peptic Ulcer Disease?

A more technical term for a deep sore on the body or within the body is an ulcer. A peptic ulcer, also called peptic ulcer disease, is a defect in the gastric or duodenal mucosa extending to the submucosa. The duodenum is the very first part of the intestines that attaches directly to the stomach.

What's important to note is that the peptic ulcer that can occur there or in the stomach isn't just a defect in the superficial-most lining of the stomach and duodenum, the protective mucosa, but is one that also extends down to the deeper, underlying, submucosal layer. This is in contrast to an erosion, which is a defect in the mucosa only.

To picture this a bit better, imagine peeling an orange. If you scrape into an orange and only take off the very top layer of it without exposing the fleshy part, that's an erosion. If you scrape really deeply into it to the point that the juice begins squirting into your eye, that's an ulcer.

In very serious cases, an ulcer may actually penetrate through all the layers of the stomach or duodenum, resulting in something called a perforating ulcer, which is a medical emergency of serious proportions. That's because highly corrosive stomach acid or bacteria from the intestines will leak into your abdomen, causing life-threatening problems. That's why taking care of an ulcer before it's too late is so critical.

Why Does Peptic Ulcer Disease Occur?

The causes of a gastric or duodenal ulcer, a peptic ulcer, are quite varied. The two most common causes for it are a bacterium and a certain class of drugs.

The bacterium is called Helicobacter pylori, or H. pylori for short. This is a Gram-negative bacterium found living below the mucus that protects the stomach from the acid it also produces.

Well, the mucus doesn't just protect the stomach from stomach acid; it also helps to protect H. pylori as H. pylori burrows underneath it. It's kind of like how people in those survivor shows bury themselves under the snow to protect themselves from the much colder air. The same type of deal happens here, but with stomach acid and gooey mucus.

Many times, this bacterium causes no harm to the person, but other times it initiates a process of inflammation of the stomach lining, correctly called gastritis, which eventually leads to ulceration by way of destruction of the stomach tissue. H. pylori doesn't just harm the mucosal protection of the GI tract; it also causes the stomach to actually produce more acid by way of indirectly increasing gastrin secretion, thereby creating even more problems! Gastrin is a hormone produced by G cells of the stomach that promotes acid secretion by the parietal cells of the stomach.

The other major way by which people get peptic ulcers is by using a class of drugs called NSAIDs, or nonsteroidal anti-inflammatory drugs, such as aspirin, ibuprofen, and naproxen. The more you use these drugs - the more often and in higher quantities - the more likely you are to develop an NSAID-induced peptic ulcer.

The use of some of these NSAIDs alters the production of important compounds called prostaglandins that protect the stomach's lining by increasing the amount of protective mucus that is secreted. NSAIDs also decrease the blood flow to the gastrointestinal tract among many other things. All of these alterations either directly damage the stomach and duodenum or do not allow for their proper repair.

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