Peptic ulcer disease refers to ulcers that can form in the lower esophagus, stomach, or duodenum. Ulcers occur when there is an imbalance between the erosive effects of gastric juice, which has a high acid content, and neutralizing factors that protect the digestive system lining. The most common causes of peptic ulcers are infection with H. pylori bacteria and chronic use of nonsteroidal anti-inflammatory drugs. Other potential causes include certain infections, drugs, toxins, diseases, and idiopathic hypersecretory states.

1. PUD (Peptic Ulcer Disease)
Dr. Alim Al Razy
Intern, Medicine Unit 1
Under prof, Dr Gautam Kumar Roy

2. The term ‘peptic ulcer’ refers to an
ulcer in the lower oesophagus, stomach
or duodenum, in the jejunum after
surgical anastomosis to the stomach or,
rarely, in the ileum adjacent to a
Meckel’s diverticulum.

3. .

4. STOMACH

5. Gastric Gland

6. Secretion Of HCL

7. Gastric Juice

8. Properties Of Gastric Juice
• Volume : 1200ml/day
• pH : 0.9 – 1.2

9. This High acidic environment
cant destroy the lining of our
Digestive system because there
are some
NEUTRALIZING FACTORS

10. When there is IMBALANE between the
erosive effect of GASTRIC JUICE and
NEUTRALIZING FACTORS,
PEPTIC ULCER occurs

11. Causes of Peptic Ulcer -
.

12. Gastric infection with the bacterium
H. pylori
(Most common causes)

13. Chronic use of NSAID

14. Non-H. pylori and Non-NSAID
causes
Infection
• Cytomegalovirus
• Herpes simplex virus
• H. heilmannii
Drug/Toxin
• Bisphosphonates
• Chemotherapy
• Clopidogrel
• Crack cocaine
• Glucocorticoids (when combined with NSAIDs)
• Mycophenolate mofetil
• Potassium chloride

15. Cont..
Miscellaneous
• Basophilia in myeloproliferative disease
• Duodenal obstruction (e.g., annular pancreas)
• Infiltrating disease
• Ischemia
• Radiation therapy
• Sarcoidosis
• Crohn's disease
• Idiopathic hypersecretory state