Ministry of health protection of the republic of uzbekistan

Text В. Peptic Ulcer

There have been many bad jokes about ulcers, but the man who has one really considers it not a laughing matter. Ulcer is a common condi­tion.

What causes ulcers? A peptic ulcer, as the name says, is erosion in the lining of the digestive tract as a result of the action of the enzyme pepsin. An increase in the acid content of the gastric juice starts pepsin digesting the mucosa. Most of the symptoms are ascribed to the high degree of acidity of the juice. Not all persons with hyper-acidity must develop ulcers. The second, commonly recognized factor is emotional stress. Emotional stress produces conditions especially favourable to ul­cer formation. Peptic ulcer disease can be called a psychosomatic dis­ease; an actual bodily ailment, produced, or at least aggravated, by the mental and emotional state.
There are two very distinctive varieties of peptic ulcer — gastric and duodenal. Although they are found in two different places-the stomach and the duodenum— they look alike and cause similar distress. Gastric ulcer is caused by the hormone gastrin, secreted during the gastric phase of digestion. Distention of the stomach lining causes gastrin to be secreted from the antrum; gastrin in turn stimulates the gastric glands to work overtime. Gastric ulcers bleed into the stomach and may actually perforate the stomach wall.
Duodenal ulcer, found in the first ten inches of the small intestine, is four times as common as gastric ulcer. This is the “ulcer of stress” mentioned earlier, though the psychic factor is also present in other forms. The patient usually complains of a pain and “heartburn” after meals (within the first hour in case of gastric ulcer, from three to four hours after meal in duodenal ulcer). Besides the pain which the patient is often unable to bear, he may also suffer from frequent vomiting. If the gastric juice shows an abnormal concentration of HCL, the diagnosis is practically certain.
Since the secretion of gastric juice is excessive in all forms of peptic ulcer, proper diet should be neccessary for the suppression of secretion. This means that the diet, instead of being appetizing, has to be monotonous, in order to suppress the appetite juice. Meat and alcohol are to be forbidden.