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Esophageal ulcer: causes
Last reviewed: 20.11.2021
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There are true (peptic) and symptomatic ulcers of the esophagus.
The true ulcers of the esophagus are peptic ulcers that occur in persons suffering from hernia of the esophageal opening of the diaphragm, cardia deficiency and gastroesophageal reflux disease.
In the mechanism of development of true (peptic) ulcers, the following factors play a role:
- the effect of aggressive factors of gastric juice - hydrochloric acid and pepsin;
- dysfunction of the central nervous system and imbalance in the production of gastrointestinal hormones;
- heterotopy of the gastric mucosa and, consequently, of the cylindrical epithelium into the esophagus.
Symptomatic are called ulcers, in which there are no hernia of the esophageal aperture of the diaphragm, cardia deficiency and gasroesophageal reflux (VM Nechaev, 1997).
Etiological variants of symptomatic ulcers:
- Congestive esophageal ulcers occur in benign and malignant tumors of the esophagus, its stenoses and diverticula.
- Viral esophageal ulcers are observed in drug addicts, homosexuals and people with acquired immunodeficiency syndrome. In biopsies from the edges of these ulcers, the influenza virus, cytomegalovirus, and HIV are isolated.
- Stressed esophageal ulcers - occur with extensive skin burns, diseases of the central nervous system.
- Medicinal esophageal ulcers - arise on the background of treatment with nonsteroidal anti-inflammatory drugs, cytostatics, potassium chloride, some antibiotics (doxycycline, clindamycin). These ulcers are due to the toxic effects of these drugs on the mucosa of the esophagus.
- Decubital esophageal ulcers occur in severe patients with a permanent gastric tube.
- Esophageal ulcers in the syndromes of Sjogren and Bschetchet.