#HealthyLifeMatters: Peptic Ulcer, A Common Killer Disease

✒️ - By Aan Gray
Inflammation of the stomach, called gastritis, can lead to a peptic ulcer as pepsin and hydrochloric acid erode the stomach wall. Peptic ulcers occur even more commonly in the duodenum and occasionally in the esophagus. If untreated, they can perforate the organ and cause fatal hemorrhaging or peritonitis. Most such fatalities occur in people over age 65. There is no evidence to support the popular belief that peptic ulcers result from psychological stress. Hypersecretion of acid and pepsin is sometimes involved, but even normal secretion can cause ulceration if the mucosal defense is compromised by other causes. Most ulcers involve an acid-resistant bacterium, Helicobacter pylori, that invades the mucosa of the stomach and duodenum and opens the way to chemical damage to the tissue. Other risk factors include smoking and the use of aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs).
NSAIDs suppress the synthesis of prostaglandins, which normally stimulate the secretion of protective mucus and acid-neutralizing bicarbonate. Aspirin itself is an acid that directly irritates the gastric mucosa. At one time, the most widely prescribed drug in the United States & Africa was cimetidine (Tagamet), which was designed to treat peptic ulcers by reducing acid secretion. Histamine stimulates acid secretion by binding to sites on the parietal cells called H2 receptors; cimetidine, an H2 blocker, prevents this binding. Lately, however, ulcers have been treated more successfully with antibiotics against Helicobacter combined with bismuth suspensions such as Pepto-Bismol. This is a much shorter and less expensive course of treatment and permanently cures about 90% of peptic ulcers, as compared with a cure rate of only 20% to 30% for H2 blockers.
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