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Encyclopedia > Peptic ulcer
Peptic ulcer
Classification & external resources
Deep gastric ulcer
ICD-10 K25.-K27.
ICD-9 531-534
DiseasesDB 9819
eMedicine med/1776  ped/2341
MeSH D010437
A benign gastric ulcer (from the antrum) of a gastrectomy specimen.
A benign gastric ulcer (from the antrum) of a gastrectomy specimen.

A peptic ulcer, also known as PUD or peptic ulcer disease[1] is an ulcer of an area of the gastrointestinal tract that is usually acidic and thus extremely painful. 80% of ulcers are associated with Helicobacter pylori, a spiral-shaped bacterium that lives in the acidic environment of the stomach, however only 20% of those cases go to a doctor. Ulcers can also be caused or worsened by drugs such as Aspirin and other NSAIDs. Contrary to general belief, more peptic ulcers arise in the duodenum (first part of the small intestine, just after the stomach) than in the stomach. About 4% of stomach ulcers are caused by a malignant tumor, so multiple biopsies are needed to make sure. Duodenal ulcers are generally benign. Image File history File links Deep_gastric_ulcer. ... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) is a coding of diseases and signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or diseases, as classified by the World Health Organization (WHO). ... // K00-K93 - Diseases of the digestive system (K00-K14) Diseases of oral cavity, salivary glands and jaws (K00) Disorders of tooth development and eruption (K01) Embedded and impacted teeth (K02) Dental caries (K03) Other diseases of hard tissues of teeth (K04) Diseases of pulp and periapical tissues (K040) Pulpitis (K05... // K00-K93 - Diseases of the digestive system (K00-K14) Diseases of oral cavity, salivary glands and jaws (K00) Disorders of tooth development and eruption (K01) Embedded and impacted teeth (K02) Dental caries (K03) Other diseases of hard tissues of teeth (K04) Diseases of pulp and periapical tissues (K040) Pulpitis (K05... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ... The Disease Bold textDatabase is a free website that provides information about the relationships between medical conditions, symptoms, and medications. ... eMedicine is an online clinical medical knowledge base that was founded in 1996. ... Medical Subject Headings (MeSH) is a huge controlled vocabulary (or metadata system) for the purpose of indexing journal articles and books in the life sciences. ... Image File history File links Benign_gastric_ulcer_1. ... Image File history File links Benign_gastric_ulcer_1. ... Diagram of the stomach, showing the different regions. ... Endoscopic images of a duodenal ulcer. ... Upper and Lower gastrointestinal tract The gastrointestinal tract (GI tract), also called the digestive tract, or the alimentary canal, is the system of organs within multicellular animals that takes in food, digests it to extract energy and nutrients, and expels the remaining waste. ... Binomial name Helicobacter pylori ((Marshall 1985) Goodwin 1989) Helicobacter pylori is a helical shaped Gram-negative bacterium that colonises the mucus layer of gastric epithelium in the stomach, and also the duodenum when it has undergone gastric metaplasia. ... Aspirin, or acetylsalicylic acid (IPA: ), (acetosal) is a drug in the family of salicylates, often used as an analgesic (to relieve minor aches and pains), antipyretic (to reduce fever), and as an anti-inflammatory. ... Non-steroidal anti-inflammatory drugs, usually abbreviated to NSAIDs, are drugs with analgesic, antipyretic and anti-inflammatory effects - they reduce pain, fever and inflammation. ... In anatomy of the digestive system, the duodenum is a hollow jointed tube connecting the stomach to the jejunum. ... In biology the small intestine is the part of the gastrointestinal tract (gut) between the stomach and the large intestine and includes the duodenum, jejunum, and ileum. ... In anatomy, the stomach is a bean-shaped hollow muscular organ of the gastrointestinal tract involved in the second phase of digestion, following mastication. ... In medicine, malignant is a clinical term that means to be severe and become progressively worse, as in malignant hypertension. ... Look up Benign in Wiktionary, the free dictionary. ...


==Classification== Dr. Karl says A peptic ulcer may arise at various locations:

Contents

In anatomy, the stomach is a bean-shaped hollow muscular organ of the gastrointestinal tract involved in the second phase of digestion, following mastication. ... In anatomy of the digestive system, the duodenum is a hollow jointed tube connecting the stomach to the jejunum. ... The esophagus (also spelled oesophagus/Å“sophagus, Greek ), or gullet is an organ in vertebrates which consists of a muscular tube through which food passes from the pharynx to the stomach. ... A Meckels diverticulum is a true congenital diverticulum. ...

Symptoms and signs

Symptoms of a peptic ulcer can be:

  • Abdominal pain, classically epigastric with severity relating to mealtimes, after around 3 hours of taking a meal (duodenal ulcers are classically relieved by food, while gastric ulcers are exacerbated by it);
  • Bloating and abdominal fullness
  • Waterbrash (rush of saliva after an episode of regurgitation to dilute the acid in esophagus)
  • Nausea, and lots of vomiting
  • Loss of appetite and weight loss;
  • Hematemesis (vomiting of blood);
  • Melena (tarry, foul-smelling faeces due to oxidized iron from hemoglobin)
  • Rarely, an ulcer can lead to a gastric or duodenal perforation. This is extremely painful and requires immediate surgery.

A history of heartburn, gastroesophageal reflux disease (GERD) and use of certain forms of medication can raise the suspicion for peptic ulcer. Medicines associated with peptic ulcer include NSAID (non-steroid anti-inflammatory drugs) that inhibit cyclooxygenase, and most glucocorticoids (e.g. dexamethasone and prednisolone). Abdominal pain can be one of the symptoms associated with transient disorders or serious disease. ... Hematemesis or haematemesis is the vomiting of fresh red blood. ... In medicine, melena or melaena refers to the black, tarry feces that are associated with gastrointestinal hemorrhage. ... The most fundamental reactions in chemistry are the redox processes. ... Structure of hemoglobin. ... Gastroesophageal Reflux Disease (GERD; or GORD when spelling Å“sophageal, the BrE form) is defined as chronic symptoms or mucosal damage produced by the abnormal reflux of gastric contents into the esophagus[1]. This is commonly due to transient or permanent changes in the barrier between the esophagus and the stomach. ... Non-steroidal anti-inflammatory drugs, usually abbreviated to NSAIDs, are drugs with analgesic, antipyretic and anti-inflammatory effects - they reduce pain, fever and inflammation. ... Cyclooxygenase (COX) is an enzyme (EC 1. ... Glucocorticoids are a class of steroid hormones characterised by an ability to bind with the cortisol receptor and trigger similar effects. ... Dexamethasone is a potent synthetic member of the glucocorticoid class of steroid hormones. ... Prednisolone is the active metabolite of prednisone. ...


In patients over 45 with more than 2 weeks of the above symptoms, the odds for peptic ulceration are high enough to warrant rapid investigation by EGD (see below).


The timing of the symptoms in relation to the meal may differentiate between gastric and duodenal ulcers: A gastric ulcer would give epigastric pain during the meal, as gastric acid is secreted, or after the meal, as the alkaline duodenal contents reflux into the stomach. Symptoms of duodenal ulcers would manifest mostly before the meal — when acid (production stimulated by hunger) is passed into the duodenum. However, this is not a reliable sign in clinical practice. Gastric acid is, together with several enzymes and the intrinsic factor, one of the main secretions of the stomach. ... In anatomy, the stomach is a bean-shaped hollow muscular organ of the gastrointestinal tract involved in the second phase of digestion, following mastication. ... In anatomy of the digestive system, the duodenum is a hollow jointed tube connecting the stomach to the jejunum. ...


Complications

  • Perforated ulcer (anterior. Surface) with sudden onset of the pain, a chemical peritonitis followed by bacterial peritonitis
  • Posterior penetration (posterior. Surface), maybe to pancreas=>increased amylase-pain=>radiating to back, unrelated to meals.
  • Hemorrhage (post. Surface), bleeding from Gasteroduodenal artery.
  • Gastric Outlet Obstruction (Goo) which happens usually because of edema or scarring, most often occurs in the setting of duodenal or pyloric channel ulcers

Stress and ulcers

Despite the finding that a bacterial infection is the cause of ulcers in 80% of cases, bacterial infection does not appear to explain all ulcers and researchers continue to look at stress as a possible cause, or at least a complication in the development of ulcers. Infection is also the title of an episode of the television series Babylon 5; see Infection (Babylon 5). ... Infection is also the title of an episode of the television series Babylon 5; see Infection (Babylon 5). ...


An expert panel convened by the Academy of Behavioral Medicine research concluded that ulcers are not purely an infectious disease and that psychological factors do play a significant role.[1] Researchers are examining how stress might promote H. pylori infection. For example, Helicobacter pylori thrives in an acidic environment, and stress has been demonstrated to cause the production of excess stomach acid. This false-colored electron micrograph shows a malaria sporozoite migrating through the midgut epithelia. ...


The discovery that Helicobacter pylori is a cause of peptic ulcer has tempted many to conclude that psychological factors are unimportant. But this is dichotomised thinking. There is solid evidence that psychological stress triggers many ulcers and impairs response to treatment, while helicobacter is inadequate as a monocausal explanation as most infected people do not develop ulcers. Psychological stress probably functions most often as a cofactor with H pylori. It may act by stimulating the production of gastric acid or by promoting behavior that causes a risk to health. Unravelling the aetiology of peptic ulcer will make an important contribution to the biopsychosocial model of disease.[2] Stress (roughly the opposite of relaxation) is a medical term for a wide range of strong external stimuli, both physiological and psychological, which can cause a physiological response called the general adaptation syndrome, first described in 1936 by Hans Selye in the journal Nature. ... Gastric acid is, together with several enzymes and the intrinsic factor, one of the main secretions of the stomach. ... please be mindful of the scientific process - if you are going to edit, hold you bias in check and provide citations! The biopsychosocial model is a general model that posits that biological, psychological (which entails thoughts, emotions, and behaviors) and social factors (abbreviated BPS) all play a significant role in...


A study of peptic ulcer patients in a Thai hospital showed that chronic stress was strongly associated with an increased risk of peptic ulcer, and a combination of chronic stress and irregular mealtimes was a significant risk factor (PMID 12948263).


A study on mice showed that both long-term water-immersion-restraint stress and H. pylori infection were independently associated with the development of peptic ulcers (PMID 12465722).


Pathophysiology

Tobacco smoking, blood group, spices and other factors that were suspected to cause ulcers until late in the 20th century, are actually of relatively minor importance in the development of peptic ulcers.[3] The cigarette is the most common method of smoking tobacco. ... Blood type (or blood group) is determined, in part, by the ABO blood group antigens present on red blood cells. ... For other uses, see Spice (disambiguation). ...


A major causative factor (60% of gastric and 90% of duodenal ulcers) is chronic inflammation due to Helicobacter pylori that colonizes (i.e. settles there after entering the body) the antral mucosa. The immune system is unable to clear the infection, despite the appearance of antibodies. Thus, the bacterium can cause a chronic active gastritis (type B gastritis), resulting in a defect in the regulation of gastrin production by that part of the stomach, and gastrin secretion is increased. Gastrin, in turn, stimulates the production of gastric acid by parietal cells. The acid erodes the mucosa and causes the ulcer. An abscess on the skin, showing the redness and swelling characteristic of inflammation. ... Binomial name Helicobacter pylori ((Marshall 1985) Goodwin 1989) Helicobacter pylori is a helical shaped Gram-negative bacterium that colonises the mucus layer of gastric epithelium in the stomach, and also the duodenum when it has undergone gastric metaplasia. ... Pyloric antrum is initial portion of the pyloric part of the stomach, which may temporarily become partially or completely shut off from the remainder of the stomach during digestion by peristaltic contraction of the prepyloric sphincter; it is demarcated, sometimes, from the second part of the pyloric part of the... The mucous membranes (or mucosa) are linings of ectodermic origin, covered in epithelium, that line various body cavities and internal organs. ... Phyla/Divisions Actinobacteria Aquificae Bacteroidetes/Chlorobi Chlamydiae/Verrucomicrobia Chloroflexi Chrysiogenetes Cyanobacteria Deferribacteres Deinococcus-Thermus Dictyoglomi Fibrobacteres/Acidobacteria Firmicutes Fusobacteria Gemmatimonadetes Nitrospirae Omnibacteria Planctomycetes Proteobacteria Spirochaetes Thermodesulfobacteria Thermomicrobia Thermotogae Bacteria (singular, bacterium) are a major group of living organisms. ... Gastritis is inflammation of the gastric mucosa. ... In humans, gastrin is a hormone that stimulates secretion of gastric acid by the stomach. ... In humans, gastrin is a hormone that stimulates secretion of gastric acid by the stomach. ... Gastric acid is, together with several enzymes and the intrinsic factor, one of the main secretions of the stomach. ... The mucous membranes (or mucosa) are linings of ectodermic origin, covered in epithelium, that line various body cavities and internal organs. ...


Another major cause is the use of NSAIDs (see above). The gastric mucosa protects itself from gastric acid with a layer of mucous, the secretion of which is stimulated by certain prostaglandins. NSAIDs block the function of cyclooxygenase 1 (cox-1), which is essential for the production of these prostaglandins. Newer NSAIDs (celecoxib, rofecoxib) only inhibit cox-2, which is less essential in the gastric mucosa, and roughly halve the risk of NSAID-related gastric ulceration. Non-steroidal anti-inflammatory drugs, usually abbreviated to NSAIDs, are drugs with analgesic, antipyretic and anti-inflammatory effects - they reduce pain, fever and inflammation. ... Gastric acid is, together with several enzymes and the intrinsic factor, one of the main secretions of the stomach. ... Cyclooxygenase (COX) is an enzyme (EC 1. ... Celecoxib (INN) (IPA: ) is a non-steroidal anti-inflammatory drug (NSAID) used in the treatment of osteoarthritis, rheumatoid arthritis, acute pain, painful menstruation and menstrual symptoms, and to reduce numbers of colon and rectum polyps in patients with familial adenomatous polyposis. ... Rofecoxib (IPA: ) is a nonsteroidal anti-inflammatory drug (NSAID) developed by Merck & Co. ...


Glucocorticoids lead to atrophy of all epithelial tissues. Their role in ulcerogenesis is relatively small. Glucocorticoids are a class of steroid hormones characterised by an ability to bind with the cortisol receptor and trigger similar effects. ... Types of epithelium In biology and medicine, epithelium is a tissue composed of a layer of cells. ...


There is debate as to whether Stress in the psychological sense can influence the development of peptic ulcers (see Stress and ulcers). Burns and head trauma, however, can lead to "stress ulcers", and it is reported in many patients who are on mechanical ventilation. A benign gastric ulcer (from the antrum) of a gastrectomy specimen. ... This article includes a list of works cited or a list of external links, but its sources remain unclear because it lacks in-text citations. ... Head injury is a trauma to the head, that may or may not include injury to the brain (see also brain injury). ... mechanical or forced ventilation is the use of powered equipment, e. ...


Smoking leads to atherosclerosis and vascular spasms, causing vascular insufficiency and promoting the development of ulcers through ischemia. The cigarette is the most common method of smoking tobacco. ... In medicine, ischemia (Greek ισχαιμία, isch- is restriction, hema or haema is blood) is a restriction in blood supply, generally due to factors in the blood vessels, with resultant damage or dysfunction of tissue. ...


Overuse of Laxatives are also known to cause peptic ulcers.


A family history is often present in duodenal ulcers, especially when blood group O is also present. Inheritance appears to be unimportant in gastric ulcers. In medicine, a family history consists of information about disorders that a patients direct blood relatives have suffered from. ... ABO blood group antigens present on red blood cells and IgM antibodies present in the serum The ABO blood group system is the most important blood type system (or blood group system) in human blood transfusion. ...


Gastrinomas (Zollinger Ellison syndrome), rare gastrin-secreting tumors, cause multiple and difficult to heal ulcers. In humans, gastrin is a hormone that stimulates secretion of gastric acid by the stomach. ... Zollinger-Ellison syndrome is a disorder where increased levels of the hormone gastrin are produced, causing the stomach to produce excess hydrochloric acid. ...


Diagnosis

An esophagogastroduodenoscopy (EGD), a form of endoscopy, also known as a gastroscopy, is carried out on patients in whom a peptic ulcer is suspected. By direct visual identification, the location and severity of an ulcer can be described. Moreover, if no ulcer is present, EGD can often provide an alternative diagnosis. Endoscopic still of esophageal ulcers seen after banding of esophageal varices, at time of esophagogastroduodenosocopy In medicine (gastroenterology), esophagogastroduodenoscopy is a diagnostic endoscopic procedure that visualises the upper part of the gastrointestinal tract up to the duodenum. ... Endoscopic images of a duodenal ulcer A flexible endoscope. ... In medicine (gastroenterology), esophagogastroduodenoscopy (EGD) or upper endoscopy is a diagnostic endoscopic procedure that visualises the upper part of the gastrointestinal tract. ...


The diagnosis of Helicobacter pylori can be by: Binomial name Helicobacter pylori ((Marshall 1985) Goodwin 1989) Helicobacter pylori is a helical shaped Gram-negative bacterium that colonises the mucus layer of gastric epithelium in the stomach, and also the duodenum when it has undergone gastric metaplasia. ...

  • Breath testing (does not require EGD);
  • Direct culture from an EGD biopsy specimen;
  • Direct detection of urease activity in a biopsy specimen;
  • Measurement of antibody levels in blood (does not require EGD). It is still somewhat controversial whether a positive antibody without EGD is enough to warrant eradication therapy.

The possibility of other causes of ulcers, notably malignancy (gastric cancer) needs to be kept in mind. This is especially true in ulcers of the greater (large) curvature of the stomach; most are also a consequence of chronic H. pylori infection. Helicobacter Pylori Urease drawn from PDB 1E9Z. Urease (EC 3. ... Each antibody binds to a specific antigen; an interaction similar to a lock and key. ... Human blood smear: a - erythrocytes; b - neutrophil; c - eosinophil; d - lymphocyte. ... When normal cells are damaged or old they undergo apoptosis; cancer cells, however, avoid apoptosis. ... In medicine, stomach cancer (also called gastric cancer) can develop in any part of the stomach and may spread throughout the stomach and to other organs. ... In anatomy, the stomach is a bean-shaped hollow muscular organ of the gastrointestinal tract involved in the second phase of digestion, following mastication. ...


If a peptic ulcer perforates, air will leak from the inside of the gastrointestinal tract (which always contains some air) to the peritoneal cavity (which normally never contains air). This leads to "free gas" within the peritoneal cavity. If the patient stands erect, as when having a chest X-ray, the gas will float to a position underneath the diaphragm. Therefore, gas in the peritoneal cavity, shown on an erect chest X-ray or supine lateral abdominal X-ray, is an omen of perforated peptic ulcer disease.


Macroscopical appearance

Gastric ulcers are most often localized on the lesser curvature of the stomach. The ulcer is a round to oval parietal defect ("hole"), 2 to 4 cm diameter, with a smooth base and perpendicular borders. These borders are not elevated or irregular as in the ulcerative form of gastric cancer. Surrounding mucosa may present radial folds, as a consequence of the parietal scarring.


Microscopical appearance

A gastric peptic ulcer is a mucosal defect which penetrates the muscularis mucosae and muscularis propria, produced by acid-pepsin aggression. Ulcer margins are perpendicular and present chronic gastritis. During the active phase, the base of the ulcer shows 4 zones: inflammatory exudate, fibrinoid necrosis, granulation tissue and fibrous tissue. The fibrous base of the ulcer may contain vessels with thickened wall or with thrombosis.[4] Section of mucous membrane of human rectum. ...


Treatment

Younger patients with ulcer-like symptoms are often treated with antacids or H2 antagonists before EGD is undertaken. Bismuth compounds may actually reduce or even clear organisms. A bottle of antacid tablets An antacid is any substance, generally a base, which counteracts stomach acidity. ... An H2-receptor antagonist, often shortened to H2-antagonist, is a drug used to block the action of histamine on parietal cells in the stomach, decreasing acid production by these cells. ... ...


Patients who are taking nonsteroidal anti-inflammatories (NSAIDs) may also be prescribed a prostaglandin analogue (Misoprostol) in order to help prevent peptic ulcers, which may be a side-effect of the NSAIDs. Wikipedia does not yet have an article with this exact name. ... Chemical structure of prostaglandin E1 (PGE1). ... An analog is in chemistry a chemical closely related to another usually sharing the same nucleus. ... Misoprostol is a drug that is United States Food and Drug Administration (FDA)-approved for the treatment and prevention of stomach ulcers. ... Look up side effect in Wiktionary, the free dictionary. ...


When H. pylori infection is present, the most effective treatments are combinations of 2 antibiotics (e.g. Erythromycin, Ampicillin, Amoxicillin, Tetracycline, Metronidazole) and 1 proton pump inhibitor (PPI). An effective combination would be Amoxicillin + Metronidazole + Pantoprazole (a PPI). In the absence of H. pylori, long-term higher dose PPIs are often used. Erythromycin is a macrolide antibiotic which has an antimicrobial spectrum similar to or slightly wider than that of penicillin, and is often used for people who have an allergy to penicillins. ... Ampicillin is a beta-lactam antibiotic that has been used extensively to treat bacterial infections since 1961. ... Amoxicillin (INN) or amoxycillin (former BAN) is a moderate-spectrum β-lactam antibiotic used to treat bacterial infections caused by susceptible microorganisms. ... Tetracycline (INN) (IPA: ) is a broad-spectrum antibiotic produced by the streptomyces bacterium, indicated for use against many bacterial infections. ... Metronidazole (INN) (IPA: ) is a nitroimidazole anti-infective drug used mainly in the treatment of infections caused by susceptible organisms, particularly anaerobic bacteria and protozoa. ... Proton pump inhibitors (or PPIs) are a group of drugs whose main action is pronounced and long-lasting reduction of gastric acid production. ... Amoxicillin (INN) or amoxycillin (former BAN) is a moderate-spectrum β-lactam antibiotic used to treat bacterial infections caused by susceptible microorganisms. ... Metronidazole (INN) (IPA: ) is a nitroimidazole anti-infective drug used mainly in the treatment of infections caused by susceptible organisms, particularly anaerobic bacteria and protozoa. ... Pantoprazole (brand names Pantopan® in Italy; Protium®; Protonix®; Pantozol®; Pantor®; Pantoloc®; Astropan) is a proton pump inhibitor drug used for short-term treatment of erosion and ulceration of the esophagus caused by gastroesophageal reflux disease. ...


Treatment of H. pylori usually leads to clearing of infection, relief of symptoms and eventual healing of ulcers. Recurrence of infection can occur and retreatment may be required, if necessary with other antibiotics. Since the widespread use of PPI's in the 1990s, surgical procedures (like "highly selective vagotomy") for uncomplicated peptic ulcers became obsolete. For the band, see 1990s (band). ... A vagotomy is a surgical procedure that is performed only in humans. ...


Perforated peptic ulcer is a surgical emergency and requires surgical repair of the perforation. Most bleeding ulcers require endoscopy urgently to stop bleeding with cautery or injection.


Epidemiology

In Western countries the prevalence of Helicobacter pylori infections roughly matches age (i.e., 20% at age 20, 30% at age 30, 80% at age 80 etc). Prevalence is higher in third world countries. Transmission is by food, contaminated groundwater, and through human saliva (such as from kissing or sharing food utensils.) In epidemiology, the prevalence of a disease in a statistical population is defined as the total number of cases of the disease in the population at a given time, or the total number of cases in the population, divided by the number of individuals in the population. ... Binomial name Helicobacter pylori ((Marshall 1985) Goodwin 1989) Helicobacter pylori is a helical shaped Gram-negative bacterium that colonises the mucus layer of gastric epithelium in the stomach, and also the duodenum when it has undergone gastric metaplasia. ... An infection is the detrimental colonization of a host organism by a foreign species. ... For the Jamaican reggae band, see Third World (band). ...


A minority of cases of Helicobacter infection will eventually lead to an ulcer and a larger proportion of people will get non-specific discomfort, abdominal pain or gastritis. Abdominal pain can be one of the symptoms associated with transient disorders or serious disease. ... Gastritis is inflammation of the gastric mucosa. ...


History

See also: Timeline of peptic ulcer disease and Helicobacter pylori

In 1997, the Centers for Disease Control and Prevention, with other government agencies, academic institutions, and industry, launched a national education campaign to inform health care providers and consumers about the link between H. pylori and ulcers. This campaign reinforced the news that ulcers are a curable infection, and the fact that health can be greatly improved and money saved by disseminating information about H. pylori.[5] Electron micrograph of This is a timeline of the events relating to the discovery that peptic ulcer disease is caused by . ... The Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia, is recognized as the leading United States agency for protecting the public health and safety of people. ... Helicobacter pylori is a bacterium that infects the mucus lining of the human stomach. ...


Helicobacter pylori was rediscovered in 1982 by two Australian scientists Robin Warren and Barry Marshall[6]. In their original paper, Warren and Marshall contended that most stomach ulcers and gastritis were caused by colonization with this bacterium, not by stress or spicy food as had been assumed before.[7] Binomial name Helicobacter pylori ((Marshall 1985) Goodwin 1989) Helicobacter pylori is a helical shaped Gram-negative bacterium that colonises the mucus layer of gastric epithelium in the stomach, and also the duodenum when it has undergone gastric metaplasia. ... J. Robin Warren (born June 11, 1937 in Adelaide) is an Australian pathologist and researcher who is credited with the 1979 discovery of the bacterium Helicobacter pylori. ... Barry James Marshall, FRS FAA (born 30 September 1951 in Kalgoorlie, Western Australia) is an Australian physician and Professor of Clinical Microbiology at the University of Western Australia. ... In medical terms, stress is the disruption of homeostasis through physical or psychological stimuli. ... Spices are strongly flavored or aromatic parts of plants used in small quantities in food as a preservative, or flavouring in cooking. ...


The H. pylori hypothesis was poorly received, so in an act of self-experimentation Marshall drank a petri-dish containing a culture of organisms extracted from a patient and soon developed gastritis. His symptoms disappeared after two weeks, but he took antibiotics to kill the remaining bacteria at the urging of his wife, since halitosis is one of the symptoms of infection.[8] This experiment was published in 1984 in the Australian Medical Journal and is among the most cited articles from the journal. Helicobacter pylori is a bacterium that infects the mucus lining of the human stomach. ... Halitosis, oral malodor (scientific term), breath odor, foul breath, fetor oris, or most commonly bad breath are terms used to describe noticeably unpleasant odors exhaled in breathing – whether the smell is from an oral source or not. ...


In 2005, the Karolinska Institute in Stockholm awarded the Nobel Prize in Physiology or Medicine to Dr. Marshall and his long-time collaborator Dr. Warren "for their discovery of the bacterium Helicobacter pylori and its role in gastritis and peptic ulcer disease". Professor Marshall continues research related to H. pylori and runs a molecular biology lab at UWA in Perth, Western Australia. The Karolinska Institutet (often translated from Swedish into English as the Karolinska Institute, and in older texts often as the Royal Caroline Institute) is a medical university in Stockholm, founded in 1810. ... List of Nobel Prize laureates in Physiology or Medicine from 1901 to the present day. ... J. Robin Warren (born June 11, 1937 in Adelaide) is an Australian pathologist and researcher who is credited with the 1979 discovery of the bacterium Helicobacter pylori. ... Gastritis is inflammation of the gastric mucosa. ... The University of Western Australia (UWA) is the oldest university in the state of Western Australia. ...


John Lykoudis was a general practitioner in Greece who treated patients from peptic ulcer disease with antibiotics long before it was commonly recognized that bacteria were a dominant cause for the disease.[9] John Lykoudis (born 1910 in Missolonghi, died 1980) was a general practitioner in Greece who treated patients from peptic ulcer disease with antibiotics long before it was commonly recognized that bacteria were a dominant cause for the disease. ... This article does not cite any references or sources. ... Peptic ulcer is a non-malignant ulcer of the stomach (called gastric ulcer) or duodenum (called duodenal ulcer). ... An antibiotic is a drug that kills or slows the growth of bacteria. ... Phyla Actinobacteria Aquificae Chlamydiae Bacteroidetes/Chlorobi Chloroflexi Chrysiogenetes Cyanobacteria Deferribacteres Deinococcus-Thermus Dictyoglomi Fibrobacteres/Acidobacteria Firmicutes Fusobacteria Gemmatimonadetes Lentisphaerae Nitrospirae Planctomycetes Proteobacteria Spirochaetes Thermodesulfobacteria Thermomicrobia Thermotogae Verrucomicrobia Bacteria (singular: bacterium) are unicellular microorganisms. ...


References

  1. ^ a b GI Consult: Perforated Peptic Ulcer. Retrieved on 2007-08-26.
  2. ^ Stress and peptic ulcer: life beyond helicobacter. Retrieved on 2007-08-26.
  3. ^ For nearly 100 years, scientists and doctors thought that ulcers were caused by stress, spicy food, and alcohol. Treatment involved bed rest and a bland diet. Later, researchers added stomach acid to the list of causes and began treating ulcers with antacids. National Digestive Diseases Information Clearinghouse
  4. ^ ATLAS OF PATHOLOGY. Retrieved on 2007-08-26.
  5. ^ Ulcer, Diagnosis and Treatment - CDC Bacterial, Mycotic Diseases
  6. ^ Marshall BJ (1983). "Unidentified curved bacillus on gastric epithelium in active chronic gastritis". Lancet 1 (8336): 1273–1275. PMID 6134060. 
  7. ^ Marshall BJ, Warren JR (1984). "Unidentified curved bacilli in the stomach patients with gastritis and peptic ulceration". Lancet 1 (8390): 1311–1315. PMID 6145023. 
  8. ^ Research Enterprise, The 2005 Nobel Prize in Physiology or Medicine. Retrieved on 2007-08-26.
  9. ^ Basil Rigas, Efstathios D. Papavasassiliou. John Lykoudis. The general parctitioner in Greece who in 1958 discovered the etiology of, and a treatment for, peptic ulcer disease. in Barry Marshall (editor), Helicobacter Pioneers. Firsthand accounts from the scientists who discovered helicobacters, 1892-1982, 2002, ISBN 0-86793-035-7.

Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era. ... is the 238th day of the year (239th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era. ... is the 238th day of the year (239th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era. ... is the 238th day of the year (239th in leap years) in the Gregorian calendar. ... The Lancet is one of the oldest and most respected peer-reviewed medical journals in the world, published weekly by Elsevier, part of Reed Elsevier. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era. ... is the 238th day of the year (239th in leap years) in the Gregorian calendar. ... Barry James Marshall, FRS FAA (born 30 September 1951 in Kalgoorlie, Western Australia) is an Australian physician and Professor of Clinical Microbiology at the University of Western Australia. ...

External links

  • Pathology specimen of Gastric ulcer
  • A case report and tutorial on perforated duodenal ulcer

  Results from FactBites:
 
Peptic Ulcers including gastric ulcer, duodenal ulcer and esophageal ulcer information at MedicineNet.com (607 words)
A peptic ulcer is a hole in the gut lining of the stomach, duodenum, or esophagus.
A peptic ulcer of the stomach is called a gastric ulcer; of the duodenum, a duodenal ulcer; and of the esophagus, an esophageal ulcer.
NSAIDs cause ulcers by interfering with prostaglandins in the stomach.
Peptic ulcer - MayoClinic.com (0 words)
Peptic ulcers are open sores that develop on the inside lining of your stomach, upper small intestine or esophagus.
Esophageal ulcers also may occur and are typically associated with the reflux of stomach acid.
Peptic ulcers are common, and oftentimes successful treatment of peptic ulcers takes just a few weeks.
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