Еtiopathogenesis

Introduction

Stomach ulcers (lat. Ulcus gastrica), a peptic ulcer disease — pertains to the disruption in the mucous membrane of the stomach (sometimes including the submucousal layer), arising from the influences of acid, pepsin, bile and trophic disruptions at the site of injury. Acid secretions in the stomach usually do not increase.

*Stomach ulcers are characterized by a recidivous current, that is alternation of the periods of aggravations (is more often in the spring or in the fall) and the remission periods. Unlike an erosion (superficial mucous defects), the ulcer heals with formation of a hem.

Сlassification

Stomach ulcer is sharp with bleeding

Stomach ulcer is sharp with perforation

Stomach ulcer is sharp with bleeding and perforation

Stomach ulcer is sharp without bleeding and perforation

Stomach ulcer is chronic or not specified with bleeding

Stomach ulcer is chronic or not specified with perforation

Stomach ulcer is chronic or not specified with bleeding and perforation

Stomach ulcer is chronic without bleeding and perforation

Stomach ulcer is not specified as sharp or chronic without bleeding or perforation

Еtiopathogenesis

The mucous secreted by the mucous membrane of the stomach has two main objectifying factors:

1) protective factors;

2) aggressive, destroying factors.

Factors of the 1st group include: the mucous developed by a mucous membrane of the stomach, which prevents the diffusion of protons across the membrane.

Factors of the 2nd group include: gastric juice (containing hydrochloric acid and pepsin — the enzyme which carries out the digestion of proteins), being the aggressive agent for tissues and infection — a microbe Helicobacter pylori. Stomach ulcers arise when the destructive action to the mucous membrane caused by aggressive factors start prevailing over the action of protective factors.

Stomach ulcers are directly connected to an infection caused by a microorganism called Helicobacter pylori. The bacteria is classed as a helicoid acidophile which thrives in the acidic environment of the stomach and mucous membrane.

The formation of stomach ulcers may also be caused by smoking, alcohol abuse (hard alcoholic drinks in particular), coffee and other caffeinated beverages, neuropsychosis, stress, depression, sharp pains during heavy traumas, burns, traumatic shock (also called "shock ulcer"), excessive intake of semi-finished food products and concentrates, spices, sour and spicy foods, peppered, salty, smoked, fried, thermally, chemically or mechanically irritating food, as well as carbonated beverages. The aggravation of symptoms may result from the ingestion of sugary food products mainly due to the increased secretion of insulin accompying the increased secretion of acid and pepsin

Figure 1: Schematic diagram on the pathogenesis of stomach ulcers- 1. H. pylori gets through the stomach lining of the individual and is attached to epithelial tissues; 2. Bacteria catalyses transformation of urea into ammonia, neutralizing the acid environment of a stomach; 3. Bacteria breed, migrate and form infectious regions 4. As a result of the destruction of the mucous membrane, inflammation and death of epithelial tissues, stomach ulcerations are formed.

Дата добавления: 2015-10-24