MEANING OF THE TERMS PEPTIC, GASTRIC AND DUODENAL ULCER
The term peptic ulcer is used to describe any localized erosion of the mucosal lining of those portions of the alimentary tract that come in contact with gastric juice. This disintegration of tissues can also result in necrosis. Majority of ulcers are found in the duodenum, although they also occur in the stomach and in the oesophagus. Similar symptoms are produced by the ulcer regardless of its location and response to treatment is the same.
In this condition there is hypersecretion of acid although tissue resistance is normal. Acid hypersecretion is due to an increased number of parietal cells and impaired rapid gastric emptying with loss of buffering effect.
Patients with gastric ulcer have weakened mucosal resistance caused by poor nutrition, diminished mucosal blood flow and a defect in the inhibition of gastric acid and pepsin secretion.
In the development of gastric ulcers although the presence of acid is essential, the degree of tissue sensitivity is important. In patients with duodenal ulcer, excess production of acid and pepsin is the primary factor. Figure 12-b shows the location of duodenal ulcer and gastric ulcer.