30.35. What is ulcer disease? What is its etiology?

Ulcer disease is chronic recidivate disease that is characterized by formation of ulcer in stomach and duodenum Nowadays etiology of ulcer disease is not determined. They think that in formation of ulcer disease of stomach and duodenum such factors are the most important:

1. long or often repeated emotional overstrain, as a rule it has negative character (negative emotions, conflict situations, feeling of constant anxiety, overfatigue)

2. stress

3. Genetic predisposition. Importance of this factor is confirmed by concerning high frequency of disease at parents and relatives of patients especially of young age. It is determined that there are in 1.5-2 ones more parietal cells at mucous membrane of health people with bad heredity than at healthy people. Symptoms of genetic predisposition are: O(I) group of blood, which often meets at patients with ulcer disease, deficit of α₁-antitripsine and fucoglycoprteins

4. mistakes in nutrition - eat cold food, non-regular, rough or piquant, bad its chewing, fast food, absence of teeth, deficiency of proteins and vitamins in food.

5. chronic gastritis and duodenitis with increased secretion activities of mucous membrane glands

6. microbe factor - Campylobacter pyloris

7. bad habits - smoking, drinking of alcohol.

30.36. What are theories of pathogenesis of ulcer disease?

1. Vascular theory (R. Virchow) Due to this theory ulcers in wall of stomach and duodenum arise as a result of disorder of blood circulation in it.

2. mechanical theory (L. Ashoff) Formation of ulcer caused by trauma of mucous membrane at small curvature by rough food.

3. inflammative theory (G. Konechnyy) At the base of ulcer formation lay inflammative changes of mucous membrane (gastritis and erosion)

4. Peptic theory (E. Rigel) It explains formation of ulcer disease wit influence of gastric juice into part of mucous membrane that mostly suffers from proteolytic influence of enzymes.

5. neural-vegetative theory (G. Bergman). It thinks that the reason of ulcer is hypersecretion of gastric juice, hypermotorics of stomach and vascular disorders at people with prevailing of parasympatic system.

6. neural-reflectory theory (I. Grekov, N. Strazhesko) It explains formation of ulcer with reflector influences on stomach in case of colitis, appendicitis, cholelithiasis;

7. cortico-visceral theory (K. Bykov, I. Kurchin). It says that main role in formation of ulcer plays breaches of conditional reflexes of brain (neurosis).

Nowadays it is formed conception that formation of ulcer takes place because of correlation of processes aggressing and defence. Factors of aggression are: increasing of enzyme activities in conditions of disorder of gastric and duodenal motorics. Decreasing of defensive qualities are caused by slowing of physiological regeneration of surface epithelium, disorder of local blood circulation and neural trophic of mucous membrane.

30.37. What pathogenic variants of gastric ulcer do they distinguish nowadays?

1. exogenous ulcer;

2. peptic ulcer;

3. hyporegeneratory ulcer;

4. trophic ulcer.