Hello and welcome to the zero to finals podcast. My name is Tom and in this episode I'm going to be

talking to you about peptic ulcers. And you can find written notes on this topic at

zero to finals.com slash peptic ulcers or in the gastroenterology section of the second edition of the Zero to Finals

Medicine book.

So let's get straight into it.

Peptic ulcers involve ulceration of the mucosa of the stomach, which is a gastric ulcer,

or the proximal duodenum, which is a duodenal ulcer.

Duodino ulcers are more common.

Let's talk about the pathophysiology.

The mucosa, also known as the mucus membrane, is the inner lining of the stomach and the

duodenum.

It secretes mucus that coats the surface and forms a barrier that

protects it against the stomach's content, particularly the stomach acid and digestive enzymes.

It secretes bicarbonate into this mucous coating to neutralize the stomach acid.

Factors that disrupt the mcus barrier or increase stomach acid increase the risk of mucosal

ulceration.

So let's talk about the risk factors.

The key risk factors that disrupt the mucus barrier are helicobacter pylori infection, or H. pylori, and non-steroidal

anti-inflammatory drugs, or ensades. The key risk factors that increase stomach

acid are stress, alcohol, caffeine, smoking and spicy foods. The risk of bleeding from

a peptic ulcer is increased with the use of ensades or non-steroidal anti-inflammatory

drugs, aspirin, anticoagulants, for example, doax or warfarin, steroids, and SSRI antidepressants.

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