Peptic ulcer - etiology and pathogenesis

Berndt, H.

Zeitschrift für die Gesamte Innere Medizin und ihre Grenzgebiete 30(19): 618-624

1975


ISSN/ISBN: 0044-2542
PMID: 1202770
Document Number: 91641
On account of its frequency, its severe sequelae for individual and society and an account of the hitherto insufficient possibilities for prevention and cure the peptic ulcer of the stomach and the duodenum is a severe problem in health policy. To the conditions of development known from epidemiology belong genetic as well as environmental factors. For the participation of genetic predispositions plead among others the familial accumulation and the connection with ABO-blood-groups. Environmental factors are evidently more important. Conspicuous are geographic differences and temporary trends of the frequency of ulcer. Psychosocial factors is attributed an important role among the developmental conditions. Ventricular ulcer and duodenal ulcer differ epidemiologically and pathophysiologically. In the ventricular ulcer the question is apparantly the local expression of a diffuse lesion of the mucous membrane. Due to a lesion of the barrier of the mucous membrane the increased rediffusion of hydrogen ions is the cause. Reflux of the duodenal juice, drugs and disturbances of circulation participate in this. In the duodenal ulcer the mucous membrane is healthy, but is not able to resist the increased and prolonged exposition to hydrochloric acid and pepsin. Disturbances of the nervous and humoral regulation of the production of acid and its inhibition are apparantly the cause.

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