A peptic ulcer is a circumscribed lesion that develops in the mu-cous membranes of the lower esophagus, stomach, duodenum, or jejunum.
The five major causes of peptic ulcers are:
· bacterial infection with Helicobacter pylori
· the use of nonsteroidal anti-inflammatory drugs (NSAIDs)
· hypersecretory states such as Zollinger-Ellison syndrome (a condition in which excessive secretion of gastric acid causes pep-tic ulcers)
· cigarette smoking, which causes hypersecretion and impairs ulcer healing
· a genetic predisposition, which accounts for 20% to 50% of peptic ulcers.
Peptic ulcer drugs are aimed at either eradicating H. pylori orrestoring the balance between acid and pepsin secretions and the GI mucosal defense. These drugs include:
§ systemic antibiotics
§ Histamine-2 (H2) receptor antagonists
§ proton pump inhibitors
§ other peptic ulcer drugs, such as misoprostol and sucralfate.