Mucosal barrier and peptic ulcer

1. Mucosal Barrier And Peptic Ulcer

2. GASTRIC MUOSAL BARRIER The gastric  mucosal barrier is the property of the stomach that allows it to contain acid If the barrier is broken , then the acid diffuses back into the mucosa and damage the stomach wall The gastric mucosal barrier is made up of 3 components

3. CONT’D compact epithelial cell lining with tight junctions Gastric mucus covering(gel like coating ) Bicarbonate ions, secreted by the surface epithelial cells. The bicarbonate ions act to neutralize harsh acids

4. MUCOSAL BARRIER

5. Mucus Mucus is secreted by mucus cells Present allover the GIT Acts as a protectant and lubricant of wall of gut Mucus is a viscous gel which contains mucin , phospholipids, electrolytes (mainly HCO3 )and water Separates the epithelial cells from acid of stomach

6. Cont’d This maintains the Ph of epithelial cells alkaline despite gastric acid Mucus is strongly resistant to digestion by gastric enzymes Has buffering properties( neutralize acid ) Helps in propulsive movement by lubrication Easy slippage of food

7. PEPTIC ULCER Ulcer :- An  Ulcer  is a discontinuity or break in a bodily membrane  ,or breach in the epithelium Ulcer and occur anywhere in the body When it occurs in stomach its gastric ulcer In duodenum its duodenal ulcer

8. Cont’d Ulcer occurring in either of these two sites is called peptic ulcer Its also known as acid peptic disease

9. Pathophysiology Of Peptic Ulcer Defect in the mucosal barrier Hyper secretion of acid Helicobacter bacterial infection

10. Defect In The Mucosal Barrier If the secretion of mucus is impaired Or bicarbonate production is impaired Such damage is caused by drugs like asprin , NSAID Chronic stress conditions (stress ulcer )

11. Hypersecretion Of Acid Chronic anxiety Common in people with busy life style Hurry , worry , curry Intake of spicy food –leads to hyperchlorhydria Conditions with hyperchlorhydria ( Zollinger ellison syndrome ) gastrin secreting tumor

12. H.Pylori Infection Major cause of peptic ulcer This bacterial infection causes Damage to the mucosal barrier Increase in gastrin secretion from G cells Reduce somatostatin from D cells Initially causes gastritis which later on leads to peptic ulcer

13. Symptoms Of Peptic Ulcer Upper abdominal pain Pain usually by empty stomach relieved by food or antacid Vomiting Blood vomiting and perforation in severe cases

14. Factors That Stimulate Acid Secretion Acetylcholine Gastrin Histamine

15. Treatment Anti histamines Anticholinergic drugs Proton pump blockers Sucralfate Gastrin blockers Antacids

16. Non Specific Treatment Avoid stress Adequate sleep Regulation of diet Avoid spicy foods , alcohol Withdrawal of drugs like aspirin, NSAIDS

17. Surgical Treatment Vagotomy Gastrectomy