RISK FACTOR OF PEPTIC ULCER DISEASES

[Mpimba]

1.NSAIDs-Induced Disease

NSAIDs represent one of the most commonly used medications

  The spectrum of NSAID-induced morbidity  ranges from  nausea and dyspepsia to a serious gastrointestinal  complication such  as frank peptic ulceration complicated by bleeding or perforation. Unfortunately, dyspeptic symptoms  do not  correlate with NSAID-induced pathology. Over 80% of patients with serious NSAID-related complications do not have preceding dyspepsia.   In view of the lack of warning signs, it is  important to identify patients who are at increased risk  for morbidity and mortality related to NSAID usage.

2.Cigarette Smoking  

Not only have smokers been found to have ulcers more frequently than do nonsmokers, but smoking appears to decrease  healing rates, impair response to therapy and increase ulcer-related  complications such as perforation.The mechanism  responsible for increased  ulcer diathesis in smokers is unknown.

3.Genetic Predisposition  

First-degree relatives of DU  patients are three times as likely to develop an ulcer. However, the potential role of  H. pylori  infection in contacts is a major consideration.  Increased frequency in people with blood group O. However, H. pylori preferentially bind to group  O antigens. Therefore, the role of genetic predisposition in common PUD  has not been established

4.Psychological Stress ,But studies examining the role of psychological factors in its pathogenesis have generated conflicting results.  Although PUD is associated with certain personality traits (neuroticism), these same traits are also present in individuals with non-ulcer dyspepsia (NUD) and other functional and organic disorders.  •  Although more work in this area is needed, no typical PUD personality has been found.

5.Diet

Certain foods can cause dyspepsia, but no convincing studies indicate an association between ulcer formation and a specific diet. This is also true for beverages containing alcohol and caffeine

Conclusion

Multiple factors play a role in the pathogenesis of  PUD  The two predominant causes are H.  pylori infection and NSAID ingestion , Independent of the inciting or injurious agent, peptic ulcers develop as a result of an imbalance between mucosal protection/repair and aggressive factors , Gastric acid plays an essential role in  mucosal injury