PATHOPHYSIOLOGY OF PEPTIC ULCER DISEASE

Contributory factor:
Diet: caffeine intake
Alcohol and smoking
Presence of Helicobacter
pylori infection

Precipitating factors:
Age: 50-70 years
old
Gender: male

Increase hydrochloric acid

(HCL) production

Irritation of the lining (mucosal)

of the stomach, duodenum,
proximal of small intestines

Damaged mucosal
barrier
Decreased function of mucosal
cells
Decreased quality of mucus
Loss of tight junctions between

Inflammatory
process
S/Sx: Abdominal
Pain

Back diffusion of acid into

gastric mucosa

Conversion of
pepsinogen to pepsin

Further mucosal
erosion
Destruction of blood
Mucosal
injury

Ulceration

Formation of liberation
of histamine
Increase acid
secretion
Stimulation of
cholinergic
intramural plexus,
causing muscle
spasm

Bleeding/
Hemorrhage
Decreased oxygen
carrying capacity as
manifested by
decreased hemoglobin
and hematocrit level
S/Sx: Pallor,
Lightheadedness,
and weakness

S/Sx: black tarry

stools, vomiting
with the presence of
blood

Local
vasodilation
Increase capillary
permeability
Loss of plasma proteins
Mucosal edema
Loss of plasma into
gastric lumen