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Abstract

COMPLICATION, PATHOGENESIS AND MEDICATION OF PERFORATED PEPTIC ULCER: A PARADIGM SHIFT IN TODAY’S TREATMENT

Priyambada Rout*, D Pradhan and Pradyumna Kumar Behera

ABSTRACT

A peptic ulcer is an erosion in a segment of the gastrointestinal mucosa, typically in the stomach (gastric ulcer) or the first few centimeters of the duodenum (duodenal ulcer), that penetrates through the muscularis mucosa. The peptic ulcers usually occur as a result of various factors such as imbalance of acid secretion, pepsin, refluxed bile, reactive oxygen species (ROS) and functional mucosal defences that resist the acid digestion. Upper gastrointestinal (UGI) bleeding is the most frequently encountered complication of peptic ulcer disease (PUD). Most typical way for ulcer to be diagnosed is by the procedure called EsophagoGastroDuodenoscopy(EGD). PUD is most commonly associated with Helicobacter pylori infection and the use of acetylsalicylic acid (ASA) and nonsteroidal anti-inflammatory drugs (NSAIDs). H pylori is said to account for 80% of all gastric or stomach ulcers and more than 90% of all duodenal ulcers. Treatment requires a combination of several antibiotics, sometimes in combination with a proton-pump inhibitor(PPIs), H2 blockers. The persisting high incidence of peptic ulcer disease is a superimposing of two trends: a higher incidence in the growing population of elderly patient with a higher intake of NSAIDs and a lower incidence among younger patients due to a decrease in incidence and improved medical treatment. The main aim of this review article has summarise the ulcerogenic mechanism of various mediator involved in PUD.

Keywords: Peptic ulcer disease (PUD), Upper gastrointestinal (UGI), Proton Pump Inhibitor(PPI), Nonsteroidal anti-inflammatory drugs(NSAIDs), EsophagoGastro-Duodenoscopy(EGD), H pylori.


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