Acid peptic diseases

Acid Peptic Diseases

Diagram of the gastrointestinal wall of the human stomach

Acid peptic diseases encompass a group of disorders characterized by damage to the gastrointestinal tract due to the action of gastric acid and pepsin. These conditions primarily affect the stomach and the duodenum, the first part of the small intestine. The most common acid peptic diseases include peptic ulcer disease, gastritis, and gastroesophageal reflux disease (GERD).

Pathophysiology

The pathophysiology of acid peptic diseases involves an imbalance between the aggressive factors, such as gastric acid and pepsin, and the defensive mechanisms of the gastrointestinal mucosa. The mucosal barrier, bicarbonate secretion, and adequate blood flow are crucial for protecting the stomach lining from acid damage. Disruption of these protective mechanisms can lead to mucosal injury and ulceration.

Gastric Acid

Gastric acid is secreted by the parietal cells of the stomach lining. It plays a vital role in digestion and provides a barrier to pathogens. However, excessive acid production or impaired mucosal defense can result in tissue damage.

Pepsin

Pepsin is an enzyme that breaks down proteins in the stomach. It is activated in the acidic environment of the stomach and can contribute to mucosal damage if the protective barriers are compromised.

Common Acid Peptic Diseases

Peptic Ulcer Disease

Peptic ulcer disease (PUD) is characterized by the presence of ulcers in the stomach or duodenum. The most common causes include infection with Helicobacter pylori and the use of nonsteroidal anti-inflammatory drugs (NSAIDs). Symptoms often include epigastric pain, nausea, and vomiting.

Gastritis

Gastritis refers to inflammation of the stomach lining. It can be acute or chronic and is often caused by H. pylori infection, NSAIDs, or excessive alcohol consumption. Symptoms may include abdominal pain, bloating, and indigestion.

Gastroesophageal Reflux Disease (GERD)

GERD is a condition where stomach acid frequently flows back into the esophagus, leading to symptoms such as heartburn and regurgitation. Chronic GERD can result in complications like esophagitis and Barrett's esophagus.

Diagnosis

Diagnosis of acid peptic diseases typically involves a combination of clinical evaluation, laboratory tests, and imaging studies. Endoscopy is a key diagnostic tool that allows direct visualization of the gastrointestinal mucosa and biopsy if necessary. Urea breath test, stool antigen test, and serology can be used to detect H. pylori infection.

Treatment

The treatment of acid peptic diseases aims to reduce gastric acid secretion, enhance mucosal protection, and eradicate H. pylori if present. Common medications include proton pump inhibitors (PPIs), H2 receptor antagonists, and antacids. In cases of H. pylori infection, a combination of antibiotics and acid suppression therapy is used.

Prevention

Preventive measures for acid peptic diseases include avoiding NSAIDs, moderating alcohol consumption, and managing stress. For individuals with H. pylori infection, eradication therapy can prevent the development of ulcers.

Related Pages

• Gastric acid
• Peptic ulcer disease
• Gastritis
• Gastroesophageal reflux disease
• Helicobacter pylori