Peptic ulcer disease

Abstract

Peptic ulcer disease (PUD) is defined as a defect in the lining of the gastrointestinalmucosa, with appreciable depth or involvement ofthe submucosa [1]. The development of peptic ulceration is a result of an imbalance between factors potentially damaging the gastric mucosa (aggressive) and protective (defensive) factors. The former include endogenous factors (e.g., gastric acid and pepsin) and exogenous factors including chronic Helicobacter pylori (Hp) infection, use of nonsteroidal anti-inflammatory drugs (NSAIDs), consumption of alcohol, smoking, and exposure to stress [2]. The latter comprise pre-epithelial defense (secretion of mucus and bicarbonates), epithelialdefense(epithelial restitution and replication extracellular buffers including bicarbonates), and post-epithelial defense (mucosal microcirculation, tissue acid-base balance).