Peptic Ulcer Disease
Introduction.
Peptic ulcer disease is caused by infection with the spiral bacterium
Helicobacter pylori. H. pylori has been found in 70 - 100% of patients with
gastritis or gastric ulcers. It is apparent that infection, rather than stress,
causes most stomach ulcers.
Summary
- Cause: Helicobacter pylori
- Microscopy: Gram-negative curved/spirals but older cells may be cocci
or
rods
- Transmission: Fecal-oral route (human reservoir)
- Symptoms: Stomach ulcers
- Complications: Stomach cancers
- Pathogenesis: Colonization of gastric mucosa facilitated by
blocking acid secretion and by urease. Penetration of mucus via flagella.
Virulence factors such as mucinase, phospholipase, and cytotoxin damage
stomach epithelium and cause inflammation
- Diagnosis: Microscopy, urease test
- Treatment: Combination of acid pump inhibitor and antibiotics
(tetracycline + metronidazole)