Understanding the Basics of Gastric Ulcer

Ulcer is a common disease which affects a large population of the world. An ulcer is a sore or an open wound that occur on the skin or along the lining of the digestive tract due to loss of surface tissue, disintegration and necrosis of epithelial tissue and may be accompanied by the formation of pus,
haemorrhage and pain.

Ulcers are classified according to their location in the body. They include:

Peptic Ulcer: Peptic ulcer is a sore lining the stomach or duodenum. This is to be due to an imbalance between aggressive factors and defensive factors in the gastro-duodenal region.
Genital ulcer: This is an ulcer around the genital area.
Corneal ulcer: This is an inflammatory condition of the cornea.
Mouth ulcer: This is an ulcer with an open sore inside the mouth.

Peptic ulcer is the most common and it is found to be due to an imbalance between aggressive factors such as hydrochloric acid (HCl), pepsin, refluxed bile, leukotrienes (LTs), reactive oxygen species (ROS) and defensive factors which include mucus-bicarbonate barrier, prostaglandins, (PGs), mucosal blood flow, non-enzymatic and enzymatic antioxidants and some growth factors.
The two common types of peptic ulcer are:

• Gastric ulcer and 
• Duodenal ulcer

The pathophysiology of gastric ulcer is attributed to the imbalance between aggressive factors like gastric acid, infection from Helicobacter pylori and the local mucosa defences like bicarbonate secretion, mucus and prostaglandins. 

Etiological factors associated with gastric ulcer include infection from Helicobacter pylori, the use of non- steroidal anti-inflammatory drugs (NSAIDs), emotional stress, alcohol abuse and smoking.
Gastric ulcer is a type of peptic ulcer. It is a common disease and occurs when the gastric mucosa in the stomach becomes damaged and perforations lead to bleeding. 

Gastric ulcer is a deep lesion penetrating the entire thickness of the gastrointestinal tract (GIT) mucosa and muscularis mucosa which causes damage and perforation of the gastric mucosa, leading to bleeding. 

A gastric ulcer, also called stomach ulcer, is a break in the normal gastric mucosa integrity that extends through the muscularis mucosa into the submucosa or deeper. The incidence varies with the age, gender, geographical location and is associated with severe complications including haemorrhages, perforations, gastrointestinal obstruction, and high peptic activity.

Factors implicated in the pathogenesis of ulcer include the following:i.    Those associated with the organism Helicobacter pylori.
ii.    Those associated with the use of Non-steroidal anti-inflammatory drugs (NSAIDs).
iii.    Use of alcohol.
iv.    Abnormal motility.
v.    Gastric acid secretion and peptic acid activity.
vi.    Oxidative stress

Oxidative stress is a term that represents a shift in the balance between the production of reactive oxygen and a biological system's ability to readily detoxify the reactive intermediates or easily repair the resulting damage. All forms of life maintain a reducing environment within their cells. This reducing environment is preserved by enzymes that maintain the reduced state through a constant input of metabolic energy. Disturbances in this normal redox state can cause toxic effects through the production of peroxides and free radicals that damage all components of the cell, including proteins, lipids, and DNA.
Increased oxidative stress at the cellular level can come about as a consequence of many factors, including exposure to alcohol, medications, trauma, cold, infections, poor diet, toxins, radiation, or strenuous physical activity.