00:00 / 00:00
Cleft lip and palate
Congenital diaphragmatic hernia
Temporomandibular joint dysfunction
Gingivitis and periodontitis
Dental caries disease
Gastroesophageal reflux disease (GERD)
Diffuse esophageal spasm
Eosinophilic esophagitis (NORD)
Gastric dumping syndrome
Cyclic vomiting syndrome
Small bowel bacterial overgrowth syndrome
Short bowel syndrome (NORD)
Protein losing enteropathy
Small bowel ischemia and infarction
Familial adenomatous polyposis
Juvenile polyposis syndrome
Irritable bowel syndrome
Diverticulosis and diverticulitis
Non-alcoholic fatty liver disease
Cholestatic liver disease
Alcohol-induced liver disease
Alpha 1-antitrypsin deficiency
Primary biliary cirrhosis
Primary sclerosing cholangitis
Benign liver tumors
Pancreatic neuroendocrine neoplasms
Congenital gastrointestinal disorders: Pathology review
Esophageal disorders: Pathology review
GERD, peptic ulcers, gastritis, and stomach cancer: Pathology review
Inflammatory bowel disease: Pathology review
Malabsorption syndromes: Pathology review
Diverticular disease: Pathology review
Appendicitis: Pathology review
Gastrointestinal bleeding: Pathology review
Colorectal polyps and cancer: Pathology review
Neuroendocrine tumors of the gastrointestinal system: Pathology review
Pancreatitis: Pathology review
Gallbladder disorders: Pathology review
Jaundice: Pathology review
Viral hepatitis: Pathology review
Cirrhosis: Pathology review
0 / 13 complete
0 / 7 complete
|Leukocyte count||14,000 /mm3|
|Alkaline Phosphatase||110 U/L|
|Bilirubin, total||.7 mg/dL|
peptic ulcer disease p. 389
acute gastric ulcer p. 729
NSAID toxicity p. 499
gastric ulcers from p. 389
peptic ulcer disease and p. 389
associations p. 727
glycopyrrolate for p. 242
H2 blockers for p. 407
Helicobacter pylori p. , 144
misoprostol for p. 408
proton pump inhibitors for p. 407
Zollinger-Ellison syndrome p. 359
duodenal ulcer p. 373
gastric ulcers p. 389
Brittany Norton, MFA
Tanner Marshall, MS
Peptic refers to the stomach, and an ulcer is a sore or break in a membrane, so peptic ulcer disease describes having one or more sores in the stomach - called gastric ulcers - or duodenum - called duodenal ulcers- which are actually more common.
Normally, the inner wall of the entire gastrointestinal tract is lined with mucosa, which has three cell layers.
The innermost layer is the epithelial layer and it absorbs and secretes mucus and digestive enzymes.
The middle layer is the lamina propria and it contains blood and lymph vessels.
Then there’s the outermost layer which is the muscularis mucosa, and it’s a layer of smooth muscle that contracts and helps break down food.
In the stomach, there are four regions - the cardia, the fundus, the body, and the antrum.
So the epithelial layer in different parts of the stomach contains different proportions of gastric glands which secrete various substances.
Having said that, the cardia contains mostly foveolar cells that secrete mucus which is a mix of water and glycoproteins.
The fundus and the body have mostly parietal cells that secrete hydrochloric acid and chief cells that secrete pepsinogen, an enzyme that digests protein.
Finally, the antrum has mostly G cells that secrete gastrin in response to food entering the stomach. These G cells are also found in the duodenum and the pancreas, which is an accessory organ of the gastrointestinal tract.
Gastrin stimulates the parietal cells to secrete hydrochloric acid, and more broadly stimulates the growth of glands throughout the stomach.
In addition, the duodenum contains Brunner glands which secrete mucus rich in bicarbonate ions.
In fact, with all of the digestive enzymes and hydrochloric acid floating around, the stomach and duodenal mucosa would get digested if not for the mucus coating the walls and bicarbonate ions secreted by the duodenum which neutralizes the acid.
A peptic ulcer is an erosion or a break in gastric or/and duodenal mucosa. The most common causes of peptic ulcers are infection with a bacterium called Helicobacter pylori (H. pylori) and long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen. Symptoms of a peptic ulcer include abdominal pain, usually felt in the upper middle or upper left part of the abdomen, bloating, vomiting, nausea, and loss of appetite. In severe cases, a peptic ulcer can cause bleeding or a perforation in the mucosa of the stomach or duodenum. Treatment includes a combination of medications called triple therapy to kill the H. pylori bacteria and reduce acid production in the stomach. Surgery is the last optional treatment to repair the ulcer if drugs are unsuccessful.
Copyright © 2023 Elsevier, except certain content provided by third parties
Cookies are used by this site.
USMLE® is a joint program of the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME). COMLEX-USA® is a registered trademark of The National Board of Osteopathic Medical Examiners, Inc. NCLEX-RN® is a registered trademark of the National Council of State Boards of Nursing, Inc. Test names and other trademarks are the property of the respective trademark holders. None of the trademark holders are endorsed by nor affiliated with Osmosis or this website.