Gastroduodenal Ulcer Disease

DEFINITION
Erosive lesions that extend through the mucosa and into the muscularis mucosa

PATHOPHYSIOLOGY
Gastroduodenal ulcers result from single or multiple factors altering, damaging, or over-whelming the normal defense and repair mechanisms of the “gastric mucosal barrier.”
Factors that make up the “gastric mucosal barrier” and protect the stomach from ulcer formation include the mucus-bicarbonate layer over the epithelial cells, the gastric epithelial cells, gastric mucosal blood flow, epithelial cell restitution and repair, and prostaglandins produced by the gastrointestinal tract.
Factors that cause mucosal barrier damage and predispose to gastroduodenal ulcer formation include inhibiting the epithelial cell's ability to repair, decreasing the mucosal blood supply, and/or increasing gastric acid secretion.
The risk of gastroduodenal ulcer formation increases with the number of insults to the “gastric mucosal barrier.”