Peptic Ulcer Disease compared to GERD
1. Summarize the pathophysiology of Peptic Ulcer Disease as compared to GERD and explain which one his symptoms most closely represent. Support with evidence.
2. Explain the body’s natural protection against peptic ulcers from a pathophysiology standpoint. 3) What diagnostic testing may be used to further evaluate the symptoms and what might this test tell the healthcare provider?
Peptic Ulcer Disease compared to GERD
Peptic ulcer disease and GERD share the same issue, which is acidity. In peptic ulcer disease, the acid causes complications in the stomach lining, whereas, in GERD, the problem is in the esophagus (Dunlap et al., 2019). Peptic ulcer disease has two types: duodenal ulcers and gastric ulcers. Duodenal ulcers happen in the duodenum or the upper section of the small intestine, whereas gastric ulcers occur in the stomach. The main cause of peptic ulcers is the H pylori bacteria that destroy the stomach lining and the duodenum or some medications. And the acids that break the food down start getting to the stomach lining, causing pain. Symptoms of peptic ulcer disease are; weight loss, abdominal pain, vomiting, nausea, or back pain. GERD starts at the lower section of the esophagus, which connects the mouth to the stomach. When the esophagus fails to close well, the stomach acids go up, irritating the chest and throat. Some of the symptoms include sore throat, chest pain, vomiting, or difficulty swallowing.
The patient reports having burning abdominal pain. This symptom is related to peptic ulcer disease (Kavitt et al., 2019). The pain arises when the mucus layer of the stomach lining is destroyed, and stomach acids get into the stomach’s inner layer, which causes painful irritation. The patient also reports that spicy foods aggravate the problem. He drinks beer. He is also under medication whereby these are acidic and increase the acidity in the stomach, which increases abdominal pain.
Body’s Natural Protection against Peptic Ulcers
The stomach lining has a special protein called MUC1, which is essential in the body’s protection against the bacteria H pylori. This protein prevents the H pylori bacterium from coming into contact with the cell surface (Seo et al., 2019). The mucous cells produce glycoproteins known as O-glycans which act as a natural antibiotic to fight the growth of h pylori. The body’s immune system has the t cells that generate and control effector cells like neutrophils or b cells that eradicate or limit cellular bacteria.
Endoscopy is a diagnostic test that helps evaluate a patient with peptic disease symptoms. A hollow tube is inserted into the body from the mouth to the stomach and has a lens called the endoscope (Yen et al., 2021). Using the endoscope, the medical practitioner will look for ulcers that look like detached mucosal abscesses with a deformed ulcer base, which is often filled with pale fibroid exudate.
Dunlap, J. J., & Patterson, S. (2019). Peptic ulcer disease. Gastroenterology Nursing, 42(5), 451-454. https://www.researchgate.net/publication/336201515_PEPTIC_ULCER_DISEASE
Kavitt, R. T., Lipowska, A. M., Anyane-Yeboa, A., & Gralnek, I. M. (2019). Diagnosis and treatment of peptic ulcer disease. The American journal of medicine, 132(4), 447-456. https://pharmacophorejournal.com/article/an-overview-on-peptic-ulcer-disease-diagnosis-and-management-approach
Seo, J. W., Park, J. Y., Shin, T. S., & Kim, J. G. (2019). The analysis of virulence factors and antibiotic resistance between Helicobacter pylori strains isolated from gastric antrum and body. BMC gastroenterology, 19(1), 1-8. https://www.mdpi.com/2079-6382/9/10/646/pdf
Yen, H. H., Wu, P. Y., Su, P. Y., Yang, C. W., Chen, Y. Y., Chen, M. F., … & Lin, K. P. (2021). Performance comparison of the deep learning and the human endoscopist for bleeding peptic ulcer disease. Journal of Medical and Biological Engineering, 41(4), 504-513. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8397124/