Mucosal barrier and peptic ulcer

 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

 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

 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

 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

 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

 Ulcer occurring in either of these two
sites is called peptic ulcer
 Its also known as acid peptic disease

 Defect in the mucosal barrier
 Hyper secretion of acid
 Helicobacter bacterial infection

 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 )

 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

 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

 Upper abdominal pain
 Pain usually by empty stomach relieved
by food or antacid
 Vomiting
 Blood vomiting and perforation in severe
cases

 Acetylcholine
 Gastrin
 Histamine

 Anti histamines
 Anticholinergic drugs
 Proton pump blockers
 Sucralfate
 Gastrin blockers
 Antacids

 Avoid stress
 Adequate sleep
 Regulation of diet
 Avoid spicy foods , alcohol
 Withdrawal of drugs like aspirin, NSAIDS

Mucosal barrier and peptic ulcer

Mucosal barrier and peptic ulcer

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Mucosal barrier and peptic ulcer