1.What is a peptic ulcer? It is estimated that all of us have had the experience of “rotten mouth on fire”, and this kind of large or small wound that is painful to look at destroys the integrity of the oral mucosa, and if the mucosal damage exceeds the mucosal muscle layer, we call it “ulcer”. Ulcers can occur in other skin and mucous membrane tissues, and the causes and symptoms of ulcers vary from site to site. Gastrointestinal mucosal ulcers are usually related to digestive factors such as gastric acid/pepsin, so they are called “peptic ulcers” and mainly include gastric ulcer (GU) and duodenal ulcer (DU). 2.Who is prone to peptic ulcer? Peptic ulcers are common worldwide, and young adults are prone to duodenal ulcers, while gastric ulcers are more common in middle and old age. The peptic ulcer is more likely to develop in people with bad eating habits who are prone to overeating, family history of peptic ulcer, preference for tobacco and alcohol and mental stress. 3, stomach I know, but what is the duodenum? Here is a diagram of the human digestive system, from the diagram can be seen, when people eat, food from the mouth through the esophagus to the stomach, the stomach inside the stomach glands, will secrete gastric juice, gastric juice contains acid and enzymes used to digest and decompose food. After initial digestion in the stomach, food needs to be further digested and absorbed in the small intestine, and the first intestinal tube to enter is the duodenum. In simple terms, the duodenum is the section of the small intestine connected to the stomach, and its length is about the width of twelve fingers together, hence the name duodenum. 4. Why is the mucosa of the gastrointestinal tract not digested by the acids and enzymes secreted by itself? Gastric acid and pepsin, the main components of gastric juice, are extremely aggressive, mainly to break down and digest various foods more efficiently and to defend against pathogens such as bacteria, viruses, and parasites, but they also pose a threat to the mucosa of the gastrointestinal tract. The reason why the gastroduodenal mucosa can resist the strong acidic environment and digestive enzymes is that it has a series of well-developed and effective defense and self-repair mechanisms. For example, the gastric mucosa cells are able to secrete a layer of alkaline mucus that covers its surface as a way to neutralize gastric acid and resist the damage of digestive juices. 5.How exactly does a peptic ulcer form? Under normal circumstances the mucosa of the gastrointestinal tract can resist attack by digestive juices, microorganisms, alcohol and other factors through defense and repair mechanisms, but if the balance between the attack and defense factors is disrupted, the mucosa of the gastrointestinal tract may be digested by itself and cause ulcers. The two main factors that cause the imbalance are a bacterium called Helicobacter pylori (H, Pylori, Hp) and non-steroidal anti-inflammatory drugs (NSAIDS) such as aspirin and ibuprofen. Genetic factors, smoking, alcohol consumption, mental stress and other factors can also lead to increased secretion of gastric acid or weaken the mucosal defense mechanism. 6.Is peptic ulcer considered an infectious disease? Peptic ulcer is a disease closely related to infection, especially for Hp-induced peptic ulcer. H. pylori mainly lives in the mucosa of the human stomach, but can reach the mouth through gastroesophageal reflux and can be excreted in the feces. The detection rate of Hp in peptic ulcer population is as high as 70% to 90%. Evidence that ulcer recurrence rates are significantly lower after eradication of this bacterium suggests that Hp infection has an important impact on the development of peptic ulcer formation. The discovery of H. pylori changed the traditional view of “no acid, no ulcers”, and scholars Marshall and Warren were awarded the 2005 Nobel Prize in Medical Physiology for this discovery. 7. How does H. pylori cause peptic ulcers? Many people infected with Hp do not have any symptoms, but some will develop ulcers, the pathogenic mechanism has not been fully elucidated, and may be mainly related to the following principles: Hp infection will promote the secretion of gastric acid/pepsin; Hp infection causes local inflammation of the gastroduodenal mucosa; Hp can also break down the alkaline mucus layer on the surface of the mucosa, further destroying the mucosal defense barrier, etc. 8, then why anti-inflammatory painkillers can also lead to ulcers? This is mainly because these NSAIDS inhibit the synthesis of prostaglandin E in the mucosal cells of the gastrointestinal tract, which can increase blood flow in the mucosa of the gastrointestinal tract and promote the secretion of protective mucus to maintain the mucosal defense function. In addition, long-term use of NSAIDS can cause the drug to accumulate in the gastric mucosal cells, causing toxicity to the cells. nSAIDS drugs weaken the defense mechanism of the mucosa, and naturally, ulcers are likely to occur. Therefore, if you feel uncomfortable with stomach pain, do not run to the pharmacy to buy painkillers to eat, because this may not only to the disease, but also aggravate your condition. 9.What is the relationship between drinking and peptic ulcer? The main component of wine is ethanol, which can directly damage the gastric mucosa, especially on an empty stomach. And excessive drinking will affect the body’s resistance, weakening the protective effect of the gastric mucosa, easy to form ulcers. Peptic ulcer patients drinking alcohol, ethanol can act directly on the ulcer surface, delaying ulcer healing, and even cause bleeding or perforation. 10.Why does smoking cause peptic ulcers? Smoking can affect the healing of peptic ulcers and even cause ulcer perforation. “A cigarette after a meal is better than living” is the “motto” for smokers. In fact, smoking one cigarette after a meal is as harmful as smoking 10 cigarettes on a regular basis. This is because after a meal, stomach peristalsis increases significantly and a large amount of blood rushes from other parts of the body to the gastrointestinal tract, resulting in a large amount of absorption of harmful substances in smoke. Nicotine and other toxic substances in cigarettes will stimulate the secretion of gastric juices to increase, and smoke can cause bile reflux and induce ulcers if inhaled into the stomach.