Aggressive And Protective Factors For Gastroduodenal Mucosa

AGGRESSIVE AND PROTECTIVE FACTORS FOR GASTRODUODENAL MUCOSA

Aggressive factors

1.     Bacterial infection : Helicobacter pylori, a spiral shaped, unipolar flagellate is associated with inflammation of gastric mucosa which could be a cause for peptic ulcer. This can be cleared by antibiotic treatment.

2.     Genetic factors : It is more common in persons with blood group O. First degree relatives of patients with duodenal ulcer have an increased risk.

3.     Sex : Men are affected two to three times more frequently than women.

4.     Age : The incidence is high between 20 and 40 years during which time career and personal strivings are at a peak.

5.     Stress : Highly nervous and emotional individuals are more susceptible as worry, fear and anxiety lead to hypersecretion of acid and hypermotility of the stomach.

6.     Potentially irritant substances : Caffeine, aspirin and nicotine may delay healing the ulcer. Chillies, pepper, ginger, strong tea and coffee increase the secretion of hydrochloric acid and aggravate the condition.

7.     Hydrochloric acid

8.     Pepsin

9.     Rapid gastric emptying

10.                        Smoking

11.                        Alcohol

Protective Factors

1.     Prostaglandin

2.     Bicarbonate secreted by stomach

3.     Mucus

4.     Mucosal blood flow.

Symptoms

1.     Epigastric pain

2.     Heart burn occurring as deep hunger contractions 1 to 3 hours after meals is the chief complaint.

3.     The pain is dull, piercing and burning and is usually relieved by taking food.

4.     Discomfort and flatulence in the upper part of the abdomen may be present.

5.     Low plasma protein levels delay rapid and complete healing of the ulcer.

6.     Weight loss and iron deficiency anemia are common.

Treatment : Therapeutic goals :

1.     To relieve the symptoms

2.     To allow healing of ulcer

3.     To prevent complications like surgery