peptic ulcer


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ulcer

ulcer, open sore or circumscribed erosion, usually slow to heal, on the skin or mucous membranes. It may develop as a result of injury; because of a circulatory disturbance, e.g., in varicose veins or after prolonged bed rest; or in association with such diseases as tuberculosis, syphilis, or leprosy. Corneal ulcers, which result from infection, allergy, or foreign objects in the eye, can cause visual impairment if not treated promptly. Some ulcers may develop into cancer. The underlying cause must be treated as well as the ulcerous lesion.

Peptic ulcer occurs in the mucous membrane of the intestinal tract. An estimated 90% of peptic ulcers are caused by infection with a bacterium, Helicobacter pylori, strains of which promote the formation of ulcers by causing an inflammtory response in the cells of the stomach wall, making it more susceptible to the hydrochloric acid secreted by the stomach. Most commonly, it occurs in the stomach (gastric ulcer) or at the beginning of the small intestine (duodenal ulcer, the most common form) and causes abdominal pain, especially between meals.

Infection with the H. pylori bacterium, which is also associated with some stomach cancer, is very common, but not all strains promote the formation of ulcers. Approximately 50% of those over 60 in developed countries are infected; in developing countries the infection rate is much higher, and infection usually occurs earlier in life. Experts are as yet uncertain how the bacterium is spread. Around 20% of those infected develop ulcers. Peptic ulcer is found more frequently in men. Heavy aspirin or ibuprofen use and smoking increase the risk of ulcer development.

The connection of H. pylori infection with peptic ulcer was made in the early 1980s by Australian scientists Barry J. Marshall and J. Robin Warren. It previously was believed that peptic ulcers were caused by emotional stress, though since the early 1900s researchers had reported finding curved bacteria in the stomachs of dead patients with ulcers more often than in those without ulcers. Marshall and Warren were awarded the Nobel Prize in physiology or medicine in 2005 for their work. Treatment changed accordingly and now typically consists of antibiotics (such as clarithromycin or amoxicillin) plus metronidazole (Flagyl) and bismuth subsalicylate (e.g., Pepto-Bismol). For the relief of symptoms, drugs such as famotidine (Pepcid), cimetidine (Tagamet), and omeprazole (Prilosec) may also be used. Hemorrhage or perforation of peptic ulcers requires emergency medical treatment.

The full set of genes (genome) of H. pylori was determined in 1997. This achievement will help researchers design new drugs to treat and prevent diseases caused by the bacterium.

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peptic ulcer

[′pep·tik ′əl·sər]
(medicine)
An ulcer involving the mucosa, submucosa, and muscular layer on the lower esophagus, stomach, or duodenum, due in part at least to the action of acid-pepsin gastric juice.
McGraw-Hill Dictionary of Scientific & Technical Terms, 6E, Copyright © 2003 by The McGraw-Hill Companies, Inc.

peptic ulcer

Pathol an ulcer of the mucous membrane lining those parts of the alimentary tract exposed to digestive juices. It can occur in the oesophagus, the stomach, the duodenum, the jejunum, or in parts of the ileum
Collins Discovery Encyclopedia, 1st edition © HarperCollins Publishers 2005
References in periodicals archive ?
In conclusion we note that perforated peptic ulcer is a common surgical problem in our environment.
In conclusion, we report a rare case of choledochoduodenal fistula complicating a duodenal peptic ulcer and the first reported case of Bouveret syndrome secondary to choledochoduodenal fistula which was successfully managed endoscopically.
pylori IgG, incidences of peptic ulcer number (%), and complicated peptic ulcer number (%) were the highly significant difference (P < 0.0001) and were correlated.
On the basis of distribution channels, the global peptic ulcer drugs market has been segmented as hospital pharmacies, private clinics, drug stores, retail pharmacies, and e-Commerce.
The change of disease pattern in perforated peptic ulcer favors a simple repair procedure.
More recent data suggest that the proportion of cases caused by peptic ulcer disease has declined.1
For instance, SNPs of cyclo-oxygenase-1 ( COX-1 ), COX-2 , tumor necrosis factor-a ( TNF-a ), and interleukin-1[sz] ( IL-1[sz] ), which had been reported to be possibly related to aspirin-induced peptic ulcer, [sup][6],[7],[8] were chosen.
High levels of psychological stress more than doubled the odds of peptic ulcers, and the link remained statistically significant even after controlling for factors such as Helicobacter pylori infection and cigarette smoking, according to a prospective study published in the March issue of Clinical Gastroenterology and Hepatology.
Peptic ulcer was the second common cause of upper gastrointestinal bleeding in our study.
In adults histamine-2 receptor blockers proton pump inhibitors and treatment of Helicobacter pylori have already replaced the role of elective surgery in peptic ulcer disease (PUD).1 Current treatment modality has also decreased the rate of elective surgery but emergent surgical conditions such as peptic ulcer perforation ( PUP ) bleeding or obstruction have not been decreased.2 However effects of improvement in the management in children are not apparent as in adults because the literature on the subject is uncommon.Various surgical procedures have been advocated for patients with PUP ranging from simple closure with an omental patch vagotomy to gastrectomy.
Peptic ulcer (PU) disease is believed to be less common and less severe as a result of modern medical treatment [19].
Amongst the pioneer researches on blood group O's association with peptic ulcer, the work by Aird and colleagues1 showed that people with blood group O are 35% more likely to be diagnosed with peptic ulcer than those with other blood types.