By A. Sonnenberg, A. Sengupta, P. Bauerfeind (auth.), W. D. W. Rees MD, MRCP (eds.)
Over the prior decade loads of examine job has happened on each side of the gastroduodenal epithelial interface, with the typical aim of elucidating the mechanisms of mucosal safety and the way those could be compromised in peptic ulcer affliction. a main stimulus to such learn has been the belief that irregular acid secretion or its supply into the duodenum in over the top quantity can't absolutely clarify ulcer pathogenesis within the majority of sufferers. One may perhaps envisage the tummy and proximal duodenum as being in a dynamic equilibrium, with competitive luminal components, resembling acid and pepsin, being counteracted by means of protecting mucosal mechanisms. until eventually lately, the mechanisms focused on mucosal safeguard have been poorly outlined whereas the body structure and pathophysiology of acid and pepsin secretion have been elucidated. The effect that gastroduodenal mucosa was once secure via a unmarried mechanism has eventually been changed by means of a extra lifelike view, suggesting a couple of protecting zones performing in sequence. a few of these zones may well act as first or moment line defences opposed to competitive components whereas sure zones could in particular shield opposed to definite aggressors.
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Additional info for Advances in Peptic Ulcer Pathogenesis
The reason for the increased risk at higher ages is unknown but it might be owing to the age-related increase in gastritis I07 and the underlying cohort phenomenon. Aspirin, however, cannot be held responsible for the birth-cohort pattern, The first bottle of aspirin was purchased in Germany only in 1899, The decline in gastric ulcer and its geographic distribution are not matched by parallel changes in aspirin consumption. ALCOHOL CONSUMPTION AND DIETARY FIBRE Acute exposure of the stomach to concentrated solutions of alcohol disrupts mucosal defences and induces haemorrhagic erosions, Such findings in the experimental animal, however, do not necessarily apply to repeated ingestion of alcoholic beverages in man.
Dietary salt restriction - The case in favour. W. 5. (eds) The Therapeutics of Hypertension, Royal Society of Medicine Series No. 26. 243-50. (London: Academic Press) Tuomilehto,].. T. and Tanskanen, T. (1984). Trends in stomach cancer and stroke in Finland. , Fujisaku, S. and Kurihara, M. (1959). Mortality for gastric and duodenal ulcer in countries and its geographical correlation to mortality for gastric and intestinal cancer. Schweiz. Z. Path. , 22, 777-84 Sonnenberg, A (1986). Dietary salt and gastric ulcer.
During the past decades the male/female ratio of duodenal ulcer dropped from 411 to 2/1 1I9, reflecting the evening-out in the lifestyles and types of occupations of the two sexes. The 'ulcer facies' described by former clinicians to be typical of duodenal ulcer patients probably relates to the lean lineaments of hard-working people. The beneficial effect of hospitalization on ulcer healing is based on abstinence from physical work and energy expenditure I2°-1 22 . The seasonal fluctuations in ulcer relapse which became less obvious in present times followed similar fluctuations in workload.
Advances in Peptic Ulcer Pathogenesis by A. Sonnenberg, A. Sengupta, P. Bauerfeind (auth.), W. D. W. Rees MD, MRCP (eds.)