INTRODUCTION.
The ulcer in gastric mucosa is called gastric ulcer and that in duodenal mucsa is called duodenal ulcer. Peptic ulcer is benign, circumscribed loss of tissue of the gastric or duodenal mucosal wall by the digestive action of acid gastric juice. A recent increase in its incidence has occurred in years chiefly in the civilised or modernised part of the world, where an increased tempo of life experts stress producing influence on the population. It is, therefore, peptic ulcer is considered to be one of the 'stress diseases'. Peptic ulcer or duodenal ulcer manifests itself by typical syndrome and known as 'peptic syndrome'. The main symptom is the burning, aching, or growing pain in the epigastrium coming on 2 or 3 hours after food, that is when the digestion is in its full swing and the food is ready for passing from stomach to the intestine.This pain is reduced by eating bland food or drinking milk. So it is called hungur pain. Pain is relieved by taking antacids.Diagnosis is confirmed by a gastric juice analysis on a fractional meal test in old days and now a days by radilogical or gastroscopic examinations.
PHYSIOLOGY OF STOMACH.
The main function of stomach is to digest proteins by the pepsin in the presence of 2 percent hydrochloric acid secreted by by the glands in its mucos memberene , up to the stage of polypeptides. It holds the food for four hours and then passes it on the intestine through the pylorus via duodenum. The food in the stomach has an acid reaction, while digesting by alkaline trypsin in intestine going up to the stage of aminoacids, it becomes less and less acidic as it proceeds onwards in the small intestines. The gastric and pyloric mucos memberene is highly resistent to the digestive action of gastric juice which can digest any proteins taken in food. sometimes certain ulcers get heald up rapidly with out causing any symptoms. When certain abnormalities are present in human system such ulcers persist, get enlarged and produce symptoms. The exact cause is not known. The valnerability of gastric mucosa to ulcerate is due to effects of emotional changes engendered by daily life on gastric secretion, vascularity, and motility. Anxiety, irritability, or hostility, makes the gastric mucosa thickened and hyperaemic rendering the mucosa more valnerable to mechanical injury so that small erosions with bleedings could be produced. Stress and tension thus can give rise to nervous dyspepsia and other gastric disorders , creating a highly favourable local environment for ulceration.
EPIDEMIOLOGICAL FACTORS.
Age-The vulnerable decades of life for peptic ulcers are from 20 t0 50, earlier in females than in males;high incidence is in 30 in females and 40 in males.They are not absent in earlier ages,may be rare. Sex distribution is almost the same up to the adolscence and then rise in men. At the highest vulnerable age mentioned above, the duodenal ulcers are 10 to 15 times more common and gastric ulcers are 5 times common in males than women. After meno-pause the incidence in women rises.
Duodenal ulcer is commenest amongst the higher socio-economic class while gastric ulcer is common amongst the low socio-economic class in the western countries. In India duodenal ulcer is commenest amongst poor people. The duodenal ulcer is more common between doctors, engineers, lawyers, clerks, etc. It is more common in western world than in eastern world, which is also showing an increase. gastric ulcer is quite common with out class or sex distinction in south India, and etc. Heridity also a factor in the family. When present in one member they are commonly found in the other members of the identical twins. It is associated with disease and conditions, habits and life situations, personalities, nutrition, drugs, alcohol, smoking, and beverages,etc.
PREVENTION.
As it is now almost certain that the peptic or duodenal ulcer happens in certain types of personalities the preventive measures should be adopted among such groups or ulcer type of persons, such as, regularity of food habits, avoidance of drinking and smoking, relaxation following acute of mental activity of a high calibre and peridical physical and mental relxations are necessary for vulnerable people in the vulnerable age groups, avoidence of anxiety, worry, exitement, early diagnosis and proper treatment, mainly adequate rest and diet regulations. Avoid hurry, worry and curry.
