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Causes of stomach and duodenal ulcers
Last reviewed: 23.04.2024
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Causes of gastric and duodenal ulcers
- the presence of Helicobacter pylori;
- increased secretion of gastric juice and reduced activity of protective factors of the mucosa (mucoproteins, bicarbonates).
Causes of ulcerative defect formation
The destruction of the mucosa and the formation of ulcers occur due to a violation of the balance between the factors of aggression and protection.
The main factors of aggression are:
- hydrochloric acid
- Pepsin is a digestive enzyme capable of digesting proteins. In addition, aggressive factors are:
- throwing bile into the stomach (bile destroys the protective mucus)
- Disorder of evacuation of stomach contents into the duodenum (both delay and acceleration) due to impaired motor function of the stomach
- traumatic effect of food.
For protection factors include:
- insoluble gastric mucus
- the mucosa itself, which has a high capacity for restoration
- good blood supply to the mucous membrane, as well as bicarbonates produced by the pancreas.
The most important role in the development of peptic ulcer belongs to the microorganisms Helicobacter pylori (pyloric helicobacteria), discovered at the end of the 20th century , which reduce the protective properties of the mucous membrane and intensify the aggression of gastric juice. Helicobacter pylori is detected in 90% of patients with duodenal ulcer and in 85% of patients with gastric ulcer. The opinions of practical physicians and scientists on the role of Helicobacter pylori in the development of peptic ulcer are ambiguous: it is currently believed that the disease can be either associated with Helicobacter pylori, and is not associated (not associated) with this microorganism.
[6], [7], [8], [9], [10], [11]
Risk factors for gastric and duodenal ulcers
- admission of NSAIDs;
- the neuropsychic factor, primarily stress;
- hereditary and constitutional predisposition (in people with the first blood group - 0 (I) - the probability of ulcer development is higher by 30-40%);
- male;
- presence of bad habits (smoking, alcohol abuse, strong natural coffee);
- malnutrition: dry food, hasty food intake, poor chewing food, overly rough and spicy food, irregular meals, deficiency in food of proteins and vitamins;
- presence of peptic ulcer in close relatives.
It is necessary to differentiate the peptic ulcer of the stomach and duodenum from the symptomatic ulcers that arise within the gastropathy induced by the intake of NSAIDs.
Risk factors for ulcer formation when taking NSAIDs
- age over 65;
- presence in the anamnesis of a peptic ulcer and its complications, first of all bleeding;
- the need for high doses of NSAIDs;
- the need for simultaneous use of glucocorticoids;
- presence of a history of coronary artery disease;
- simultaneous reception of anticoagulants.