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Peptic ulcer disease: Duodenal ulcers

Peptic ulcer disease: Duodenal ulcers

Peptic ulcer disease: Duodenal ulcers
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>> Peptic ulcer disease: Gastric ulcers >>

Ulcers are a relatively familiar term for most of us, but what is it exactly about? Peptic ulcer disease is a general term used to designate duodenal ulcers and gastric ulcers, which in most aspects are similar, differing only in terms of localization.

An ulcer is defined as a break in the integrity of the gastric or duodenal mucosa resulting to the presence of a local defect or an active inflammation leading to excavation. These are often chronic in nature, since normally, the gastric epithelial lining has mechanisms to cope up with the continuous exposure to acid, pepsin, including bile acids, drugs, bacteria, and even pancreatic enzymes. Once the balance between mucosal damage and repair is disrupted, hence the appearance of ulcers. These disorders are very common in the United States, affecting approximately four million individuals each year.

Ulcers are breaks that are approximately greater than five millimeters in size, with its depth extending to the submucosa. Take note: unless the break extends into the submucosa, the break cannot be qualified to be called as an ulcer. Although duodenal ulcers and gastric ulcers are very much alike in terms of pathogenesis, diagnosis, and treatment, there are some features that differentiate them from each other.

First, let us take into consideration the duodenal ulcers. Occurring in approximately 6-15% of the Western population, there is a progressively decreasing incidence of duodenal ulcers in the past years. This was attributed to the discovery of Helicobacter pylori as one of the dominant causative organisms promoting ulceration. Its eradication proved to be helpful in preventing recurrent ulcers.

Duodenal ulcers are located most often at the first portion of the duodenum, and are usually less than one centimeter in diameter. Giant ulcers are also found at times. These ulcers have well-defined demarcations, with depths occasionally traversing the muscularis propria (the region or layer below the submucosa).

>> Peptic ulcer disease: Gastric ulcers >>

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