Many theories have been propounded in respect to the actual causes of peptic ulcer but none of them is conclusive.
However, the most acceptable one is that of Guyton which states that "The usual cause of peptic ulceration is an imbalance between the rate of secretion of gastric juice and the degree of protection afforded by the gastro-duodenal mucosa barrier and the neutralization of the gastric acid by duodenal juices".
There is inability of the mucosa lining of the gastrointestinal tract to resist the digestive action of hydrochloric acid and pepsin as a result of the imbalance.
There are factors that contribute to a decrease in the mucosal resistance and they include inadequate quantity of mucus, inadequate food in the GIT and inadequate regeneration of epithelial tissue that line the gastrointestinal mucosa.
However, the two major causes of peptic ulcer include: i.
Infection: The bacterium, Helicobacter Pylori has been found to be the main cause of this disease.
This bacterium weakens the protective coating of the walls of the stomach and duodenum thereby exposing them to the actions of digestive juices.
ii.
Drugs: The Non-Steroidal Anti-Inflammatory Drugs e.
g.
Aspirin, Ibuprofen, Indomethacin, Diclofenac, Phenylbutabone, Piroxicam, etc are known to erode the mucosa lining of the stomach thereby causing peptic ulcer.
This effect usually occurs after prolonged exposure to especially high doses.
Nevertheless, some patients are known to have spontaneously developed intestinal bleeding after just a few normal doses.
Predisposing factors By predisposing factors we mean those factors that make an individual susceptible to develop peptic ulcer.
These factors include: 1.
Heredity: It is known to run in families.
Researches have shown that some forms of peptic ulcer are common in people with certain blood groups.
Duodenal ulcer has been linked to people with blood group O while gastric ulcer is commoner in people with blood group A.
heredity is more of a predisposing factor and not a cause in itself.
2.
Bile reflux: When there is incompetent pyloric sphincter, there can be reflux of bile and pancreatic juices into the stomach which in turn damage the gastric mucosa and predispose one to peptic ulcer.
3.
Stress: When there is stress there is an increase in the stimulation of the vagus nerve.
This in turn leads to increase production of gastric secretions which makes one susceptible to develop peptic ulcer in the long run.
4.
Illness: Some severe systemic problems can lead to a reduction in blood supply to the mucosa thereby making one prone to "Stress Ulcer".
These conditions include Burns, hyperthyroidism, trauma, surgery, jaundice, uraemia, sepsis and respiratory failure.
5.
Inflammatory conditions: Inflammation of the lining of the stomach makes the membranes liable to digestion by gastric juices as a result of the reduction of the mucosa barrier.
6.
Sex: The incidence of peptic ulcer is higher in males than in females.
The female hormone, oestrogen has been suggested to give some form of protection to women.
7.
Drugs: Certain drugs such as Steroids, alcohol (especially whiskey or spirit) and nicotine are also known to play a vital role in the development of the condition.
The most acceptable causes of this disease include infection by Helicobacter Pylori, and the Non-Steroidal Anti-Inflammatory Drugs (NSAIDs).
Once you are able to successfully control these two factors you can reduce drastically the incidence of peptic ulcer.
However, the most acceptable one is that of Guyton which states that "The usual cause of peptic ulceration is an imbalance between the rate of secretion of gastric juice and the degree of protection afforded by the gastro-duodenal mucosa barrier and the neutralization of the gastric acid by duodenal juices".
There is inability of the mucosa lining of the gastrointestinal tract to resist the digestive action of hydrochloric acid and pepsin as a result of the imbalance.
There are factors that contribute to a decrease in the mucosal resistance and they include inadequate quantity of mucus, inadequate food in the GIT and inadequate regeneration of epithelial tissue that line the gastrointestinal mucosa.
However, the two major causes of peptic ulcer include: i.
Infection: The bacterium, Helicobacter Pylori has been found to be the main cause of this disease.
This bacterium weakens the protective coating of the walls of the stomach and duodenum thereby exposing them to the actions of digestive juices.
ii.
Drugs: The Non-Steroidal Anti-Inflammatory Drugs e.
g.
Aspirin, Ibuprofen, Indomethacin, Diclofenac, Phenylbutabone, Piroxicam, etc are known to erode the mucosa lining of the stomach thereby causing peptic ulcer.
This effect usually occurs after prolonged exposure to especially high doses.
Nevertheless, some patients are known to have spontaneously developed intestinal bleeding after just a few normal doses.
Predisposing factors By predisposing factors we mean those factors that make an individual susceptible to develop peptic ulcer.
These factors include: 1.
Heredity: It is known to run in families.
Researches have shown that some forms of peptic ulcer are common in people with certain blood groups.
Duodenal ulcer has been linked to people with blood group O while gastric ulcer is commoner in people with blood group A.
heredity is more of a predisposing factor and not a cause in itself.
2.
Bile reflux: When there is incompetent pyloric sphincter, there can be reflux of bile and pancreatic juices into the stomach which in turn damage the gastric mucosa and predispose one to peptic ulcer.
3.
Stress: When there is stress there is an increase in the stimulation of the vagus nerve.
This in turn leads to increase production of gastric secretions which makes one susceptible to develop peptic ulcer in the long run.
4.
Illness: Some severe systemic problems can lead to a reduction in blood supply to the mucosa thereby making one prone to "Stress Ulcer".
These conditions include Burns, hyperthyroidism, trauma, surgery, jaundice, uraemia, sepsis and respiratory failure.
5.
Inflammatory conditions: Inflammation of the lining of the stomach makes the membranes liable to digestion by gastric juices as a result of the reduction of the mucosa barrier.
6.
Sex: The incidence of peptic ulcer is higher in males than in females.
The female hormone, oestrogen has been suggested to give some form of protection to women.
7.
Drugs: Certain drugs such as Steroids, alcohol (especially whiskey or spirit) and nicotine are also known to play a vital role in the development of the condition.
The most acceptable causes of this disease include infection by Helicobacter Pylori, and the Non-Steroidal Anti-Inflammatory Drugs (NSAIDs).
Once you are able to successfully control these two factors you can reduce drastically the incidence of peptic ulcer.
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