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INTRODUCTION: A peptic ulcer may be referred to as a gastric, duodenal, or esophageal ulcer, depending on its location. A person who has a peptic ulcer has peptic ulcer disease. A peptic ulcer is an excavation that forms in the mucosal wall of the stomach, in the pylorus, in the duodenum, or in the esophagus. Erosion of a circumscribed area of mucous membrane is the cause. This erosion may extend as deeply as the muscle layers or through the muscle to the peritoneum. Peptic ulcers are more likely to be in the duodenum than in the stomach. As a rule they occur alone, but they may occur in multiples. Chronic gastric ulcers tend to occur in the lesser curvature of the stomach, near the pylorus. Esophageal ulcers occur as a result of the backward flow of HCl from the stomach into the esophagus. A few peptic ulcers occur in the lower esophagus, following the regurgitation of stomach contents, but most (98%) occur in the pyloric part of the stomach (gastric ulcers) or the first part of the duodenum (duodenal ulcers). Peptic ulcer disease occurs with the greatest frequency in people between 40 to 60 years old. It is relatively more uncommon to women of childbearing age, but it has been observed in children and even in infants. After menopause, the incidence of peptic ulcer disease in women is almost is equal to that of men. Peptic ulcers in the body of the stomach can occur without excessive acid secretion. In the past, stress and anxiety were thought to be causes of ulcers, but research has documented that peptic ulcers result from infection with the gram-negative bacteria H pylori, which may be acquired through ingestion of food and water. Person-to-person transmission of the bacteria also occurs through close contact and exposure to emesis. Although H pylori infection is common in the United States, most infected people do not develop ulcers. It is not known why H pylori infection does not cause ulcers in all people, but most likely the predisposition to ulcer formation depends on certain factors, such as the type of H pylori and other as yet unknown factors. Peptic ulcers affect one of every eight Americans. In addition, excessive secretion of HCl in the stomach may contribute to the formation of peptic ulcers, and stress may be associated with its increased secretion. The ingestion of milk and caffeinated beverages, smoking, and alcohol also may increase HCl secretion. Stress and eating spicy foods may make peptic ulcers worse. Familial tendency also may be a significant predisposing factor. People with blood type O are more susceptible to peptic ulcers than are those with blood type A, B, or AB; this is another genetic link. There also is an association between peptic ulcers and chronic pulmonary disease or chronic renal disease. Other predisposing factors associated with peptic ulcer include chronic use of NSAIDs, alcohol ingestion, and excessive smoking.

H. pylori infection is present in 50 to 70% of patients with duodenal ulcers and 30 to 50% of patients with gastric ulcers. If H. pylori are eradicated, only 10% of patients have recurrence of peptic ulcer disease, compared with 70% recurrence in patients treated with acid suppression alone. NSAIDs now account for > 50% of peptic ulcers. Recent studies indicate that many ulcers are actually caused by H pylori that inhabit the stomach of 40% of healthy people and 70-90% of those with ulcers. The significance of this study is to be able to figure out the leading causes in which taking into consideration the predisposing and precipitating factors of the said disease. Also, to be able to know about the different forms of peptic ulcer disease and how it can able to lead into a wide range of signs and symptoms such as nausea, vomiting, and abdominal pain.

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