Ulcer

Ulcer

An ulcer is a break in the skin or mucous membrane with loss of surface tissue, disintegration and necrosis of epithelial tissue, and often pus. Ulcers can occur in various parts of the body, including the skin, mouth, and gastrointestinal tract. This article focuses on peptic ulcer disease, particularly gastric ulcers.

Diagram of a gastric ulcer

Types of Ulcers

Ulcers are classified based on their location and cause. The most common types include:

• Gastric ulcer: Occurs in the stomach lining.
• Duodenal ulcer: Occurs in the first part of the small intestine.
• Mouth ulcer: Occurs in the oral cavity.
• Pressure ulcer: Also known as bedsores, occur due to prolonged pressure on the skin.

Gastric Ulcers

Gastric ulcers are a type of peptic ulcer disease that specifically affects the stomach lining. They are characterized by:

• Location: Typically found on the lesser curvature of the stomach.
• Symptoms: Include burning stomach pain, bloating, heartburn, and nausea.
• Causes: Often caused by Helicobacter pylori infection or the use of nonsteroidal anti-inflammatory drugs (NSAIDs).

Pathophysiology

The development of gastric ulcers involves an imbalance between aggressive factors, such as gastric acid and pepsin, and defensive factors, such as the mucosal barrier and bicarbonate secretion. Helicobacter pylori infection disrupts the mucosal barrier, leading to inflammation and ulceration.

Diagnosis

Diagnosis of gastric ulcers typically involves:

• Endoscopy: Allows direct visualization of the ulcer.
• Biopsy: To rule out malignancy and test for Helicobacter pylori.
• Urea breath test: To detect Helicobacter pylori infection.

Treatment

Treatment of gastric ulcers focuses on:

• Eradicating Helicobacter pylori: Using a combination of antibiotics and proton pump inhibitors (PPIs).
• Reducing acid production: With PPIs or H2-receptor antagonists.
• Protecting the gastric lining: Using agents like sucralfate.

Complications

Potential complications of untreated gastric ulcers include:

• Bleeding: Can lead to hematemesis or melena.
• Perforation: A hole in the stomach wall, leading to peritonitis.
• Gastric outlet obstruction: Due to swelling or scarring.

Related Pages

• Peptic ulcer disease
• Helicobacter pylori
• Gastroesophageal reflux disease
• Nonsteroidal anti-inflammatory drug