Cause of chronic peptic ulcer

Aetiology     or Cause of chronic peptic ulcer:-

1)      Heredity : patients with peptic ulcer often have a family history of the disease.  This is particularly the case with duodenal ulcers, which develop below the age of 20 years.  The relatives of gastric ulcer patients have 3 times the expected number of gastric ulcer but duodenal ulcer occur with the same frequency amongst relatives as in the general population.

2)      Acid-pepsin Vs. Mucosal resistance :- The immediate cause of peptic ulceration is digestion of the mucosa by acid and pepsin of the gastric juice, but the sequence of events leading to this is unknown. Digestion by acid and pepsin can’t be the only factor involved, since the normal stomach in obviously capable of resisting digestion by its own secretion.

The concept of ulcer aetiology may be written as “acid plus pepsin Vs. mucosal resistance”.

3)      Gastric hyper secretion :- Ulcer occur only in the presence of acid and pepsin they are never found in achlorhydric patients such as those with pernicious anaemia.  Acid secretion is more important in the aetiology of duodenal than gastric ulcer.

Peptic ulcer is the most common gastrointestional disorder in clinical practice. However, several classes of agents like H₂ blockers, proton pump inhibitor are being used as effective line of treatment of peptic ulcer. The several side effects associated with the present line of treatment, like Arrythemias, impotence, gynacomastia and hematopoetic changes, of synthetic drugs, etc., limits the usage of there agents for a chronic period is restricted. Comparatively indigenous drugs are possessing fewer side effects. Hence, the search for better alternatives for synthetic drugs is on rise.