​Pathology - Peptic Ulcer Disease

​Pathology - Peptic Ulcer Disease
Gastric (G) ulcers are primarily caused by H pylori infection in 70% of cases, as well as the use of NSAIDs. They are more commonly observed in older people.
Duodenal (D): H pylori infection is observed in younger people and those with blood group O.
Peptic ulcer disease can develop due to chronic gastritis, smoking, Zollinger-Ellison syndrome, hyperparathyroidism, and MEN type I.
Pathological: A lesion characterized by a loss of mucosal tissue, exhibiting well-defined, circular edges, typically found in the antral and prepyloric regions or in the first section of the duodenum (D).
Microscopic examination reveals different characteristics depending on the stage of the ulcer. Active ulcers show the presence of necrotic fibrinoid debris along with an infiltration of neutrophils, which finally leads to the formation of granulation tissue. Additionally, there is an enlargement of the Brunner glands (D).
Pathophysiology refers to the study of the functional changes that occur in the body as a result of a disease or injury. Gastritis (G) occurs due to a reduction in the mucosal defense against stomach acid. Dyspepsia occurs due to heightened stomach acid and pepsin production, along with reduced mucosal defense in (D) 
Gastric: Experiencing pain in the upper abdomen that intensifies after eating; accompanied by a decrease in body weight. Laboratory results indicate reduced hydrogen ion release and elevated amounts of gastrin.
Duodenal: The pain in the upper abdomen lessens after eating; accompanied by an increase in body weight. Laboratory results indicate an elevated level of hydrogen ion (H+) secretion.

Possible complications encompass gastrointestinal hemorrhage resulting in iron deficiency anemia, perforation, and obstruction. Treatment options include proton pump inhibitors or H2-receptor antagonists. Administer triple therapy consisting of bismuth, metronidazole, and tetracycline or amoxicillin to address H pylori infection. Endoscopy for the management of actively hemorrhaging ulcers.
Peptic ulcer illness does not serve as a precursor to gastric cancer.