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Peptic Ulcer Disease

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Metabolism of Human Diseases

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Abstract

Peptic ulcer disease (PUD) is defined as a defect in the lining of the gastrointestinal mucosa, with appreciable depth or involvement of the submucosa [1]. The development of peptic ulceration is a result of an imbalance between factors potentially damaging the gastric mucosa (aggressive) and protective (defensive) factors. The former include endogenous factors (e.g., gastric acid and pepsin) and exogenous factors including chronic Helicobacter pylori (Hp) infection, use of nonsteroidal anti-inflammatory drugs (NSAIDs), consumption of alcohol, smoking, and exposure to stress [2]. The latter comprise pre-epithelial defense (secretion of mucus and bicarbonates), epithelial defense (epithelial restitution and replication, extracellular buffers including bicarbonates), and post-epithelial defense (mucosal microcirculation, tissue acid-base balance).

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References

  1. Malfertheiner P, Chan FK, McColll KE (2009) Peptic ulcer disease. Lancet 374:1449–1461

    Article  CAS  PubMed  Google Scholar 

  2. Konturek PC (1997) Physiological, immunohistochemical and molecular aspects of gastric adaptation to stress, aspirin and to H. pylori-derived gastrotoxins. J Physiol Pharmacol 48:3–42

    CAS  PubMed  Google Scholar 

  3. Tytgat GNJ (2011) Ethiopathogenetic principles and peptic ulcer disease classification. Dig Dis 29:454–458

    Article  CAS  PubMed  Google Scholar 

  4. Choung RS, Talley NJ (2008) Epidemiology and clinical presentation of stress-related peptic damage and chronic peptic ulcer. Curr Mol Med 8(4):253–257

    Article  CAS  PubMed  Google Scholar 

  5. Milosavljevic T, Kostić-Milosavljević M, Jovanović I, Krstić M (2011) Complications of peptic ulcer disease. Dig Dis 29:491–493

    Article  PubMed  Google Scholar 

  6. Graham DY, Kato M, Asaka M (2008) Gastric endoscopy in the 21st century: appropriate use of an invasive procedure in the era of non-invasive testing. Dig Liver Dis 40(7):497–503

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Schwarz K (1910) Über penetrierende Magen- und Jejunalgeschwüre. Beitr Klin Chir 67:96–128

    Google Scholar 

  8. Tarnawski AS, Ahluwalia A, Jones MK (2012) The mechanisms of gastric mucosal injury: focus on microvascular endothelium as a key target. Curr Med Chem 19(1):4–15

    Article  CAS  PubMed  Google Scholar 

  9. Graham DY, Lew GM, Klein PD, Evans DG, Evans DJ Jr, Saeed ZA, Malaty HM (1992) Effect of treatment of Helicobacter pylori infection on the long-term recurrence of gastric or duodenal ulcer. A randomized, controlled study. Ann Intern Med 116(9):705–708

    Article  CAS  PubMed  Google Scholar 

  10. Marshall BJ (1995) The 1995 Albert Lasker Medical Research Award. Helicobacter pylori. The etiologic agent for peptic ulcer. JAMA 274(13):1064–1066

    Article  CAS  PubMed  Google Scholar 

  11. Konturek PC, Konturek SJ, Bobrzynski A, Kwiecien N, Obtulowicz W, Stachura J, Hahn EG, Rembiarz K (1997) Helicobacter pylori and impaired gastric secretory functions associated with duodenal ulcer and atrophic gastritis. J Physiol Pharmacol 48(3):365–373

    CAS  PubMed  Google Scholar 

  12. McColl KE, El-Omar E, Gillen D (2000) Helicobacter pylori gastritis and gastric physiology. Gastroenterol Clin North Am 29(3):687–703

    Article  CAS  PubMed  Google Scholar 

  13. Malfertheiner P, Leodolter A, Peitz U (2000) Cure of Helicobacter pylori-associated ulcer disease through eradication. Baillieres Best Pract Res Clin Gastroenterol 14(1):119–132

    Article  CAS  Google Scholar 

  14. Takeuchi K (2012) Pathogenesis of NSAID-induced gastric damage: importance of cyclooxygenase inhibition and gastric hypermotility. World J Gastroenterol 18(18):2147–2160

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Chan FKL, Leung WK (2002) Peptic ulcer disease. Lancet 360:933–941

    Article  PubMed  Google Scholar 

  16. Gisbert JP, Calvet X (2009) Review article: Helicobacter pylori-negative duodenal ulcer. Aliment Pharmacol Ther 30:791–815

    Article  CAS  PubMed  Google Scholar 

  17. Maity P, Biswas K, Roy S, Banerjee RK, Bandyopadhyay U (2003) Smoking and the pathogenesis of gastroduodenal ulcer-recent mechanistic update. Mol Cell Biochem 253(1–2):329–338

    Article  CAS  PubMed  Google Scholar 

  18. Franke A, Teyssen S, Singer MV (2005) Alcohol-related diseases of the esophagus and stomach. Dig Dis 23(3–4):204–213

    Google Scholar 

  19. Shimamoto T, Yamamichi N, Kodashima S, Takahashi Y, Fujishiro M, Oka M, Mitsushima T, Koike K (2013) No association of coffee consumption with gastric ulcer, duodenal ulcer, reflux esophagitis and non-erosive reflux disease: a cross-sectional study of 8,013 healthy subjects in Japan. PLoS One 8(6):e65996

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Selgrad M, Malfertheiner P (2011) Treatment of Helicobacter pylori. Curr Opin Gastroenterol 27(6):565–570

    Article  CAS  PubMed  Google Scholar 

  21. Chan FK, Ching JY, Suen BY, Tse YK, Wu JC, Sung JJ (2013) Effects of Helicobacter pylori infection on long-term risk of peptic ulcer bleeding in low-dose-aspirin users. Gastroenterology 144(34):528–535

    Article  CAS  PubMed  Google Scholar 

  22. Malfertheiner P, Megraud F, O’Morain C, Bazzoli F, El-Omar E, Graham D, Hunt R, Rokkas T, Vakil N, Kuipers EJ (2007) Current concepts in the management of Helicobacter pylori infection: the Maastricht III Consensus Report. Gut 56(6):772–781

    Article  CAS  PubMed  Google Scholar 

  23. Sachs G, Shin JM, Hunt R (2010) Novel approaches to inhibition of gastric acid secretion. Curr Gastroenterol Rep 12(6):437–447

    Article  PubMed Central  Google Scholar 

  24. Holle GE (2010) Pathophysiology and modern treatment of ulcer disease. Int J Mol Med 25(4):483–491

    Article  CAS  PubMed  Google Scholar 

  25. Holster IL, Kuipers EJ (2011) Update on the endoscopic management of peptic ulcer bleeding. Curr Gastroenterol Rep 13:525–531

    Article  PubMed  PubMed Central  Google Scholar 

  26. Lee CW, Sarosi GA Jr (2011) Emergency ulcer surgery. Surg Clin North Am 91(5):1001–1013

    Article  PubMed  Google Scholar 

  27. Ford AC, Delaney BC, Forman D, Moayyedi P (2006) Eradication therapy for peptic ulcer disease in Helicobacter pylori positive patients. Cochrane Database Syst Rev (2):CD003840

    Google Scholar 

  28. Graham DY, Calvet X (2012) Guide regarding choice of second-line therapy to obtain a high cumulative cure rate. Helicobacter 17:243–245

    Article  PubMed  PubMed Central  Google Scholar 

  29. McColl KE (1997) Helicobacter pylori and acid secretion: where are we now? Eur J Gastroenterol Hepatol 9(4):333–335

    Article  CAS  PubMed  Google Scholar 

  30. Konturek SJ (1993) New aspects of clinical pharmacology of antacids. J Physiol Pharmacol 44(3 Suppl 1):5–21

    CAS  PubMed  Google Scholar 

  31. Warner CW, McIsaac RL (1991) The evolution of peptic ulcer therapy. A role for temporal control of drug delivery. Ann N Y Acad Sci 618:504–516

    Article  CAS  PubMed  Google Scholar 

  32. Huang JQ, HRH (2001) Pharmacological and pharmacodynamic essentials of H2-receptor antagonists and proton pump inhibitors for the practising physician. Best Pract Res Clin Gastroenterol 15(3):355–370

    Google Scholar 

  33. Mössner J, Caca K (2005) Developments in the inhibition of gastric acid secretion. Eur J Clin Invest 35(8):469–475

    Article  PubMed  Google Scholar 

  34. Williams C, McColl KE (2006) Review article: proton pump inhibitors and bacterial overgrowth. Aliment Pharmacol Ther 23(1):3–10

    Article  CAS  PubMed  Google Scholar 

  35. Abraham NS (2012) Proton pump inhibitors: potential adverse effects. Curr Opin Gastroenterol 28(6):615–620

    Article  CAS  PubMed  Google Scholar 

  36. Reskin JB, White RH, Jackson JE, Weaver AL, Tindall EA, Lies RB, Stanton DS (1995) Misoprostol dosage in the prevention of non-steroidal anti-inflammatory drug-induced gastric and duodenal ulcers: a comparison of three regimens. Ann Intern Med 123:344–350

    Article  Google Scholar 

  37. Konturek SJ, Brzozowski T, Majka J, Szlachcic A, Bielanski W, Stachura J, Otto W (1993) Fibroblast growth factor in the gastroprotection and ulcer healing: interaction with sucralfate. Gut 34(7):881–887

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  38. Hall DW (1989) Review of the modes of action of colloidal bismuth subcitrate. Scand J Gastroenterol Suppl 157:3–6

    Article  CAS  PubMed  Google Scholar 

  39. Song KH, Lee YC, Fan DM, Ge ZZ, Ji F, Chen MH, Jung HC, Bo J, Lee SW, Kim JH (2011) Healing effects of rebamipide and omeprazole in Helicobacter pylori-positive gastric ulcer patients after eradication therapy: a randomized double-blind, multinational, multi-institutional comparative study. Digestion 84:221–229

    Article  CAS  PubMed  Google Scholar 

  40. Konturek PC, Bielanski W, Konturek SJ, Hahn EG (1999) Helicobacter pylori associated gastric pathology. J Physiol Pharmacol 50(5):695–710

    CAS  PubMed  Google Scholar 

  41. Al-Jiboury H, Kaunitz JD (2012) Gastroduodenal mucosal defense. Curr Opin Gastroenterol 28(6):594–601

    Article  CAS  PubMed  Google Scholar 

  42. Celinski K, Konturek SJ, Konturek PC, Brzozowski T, Cichoz-Lach H, Slomka M, Bielanski W, Reiter RJ (2011) Melatonin or L-tryptophan accelerates healing of gastroduodenal ulcers in patients treated with omeprazole. J Pineal Res 50(4):389–394

    Article  CAS  PubMed  Google Scholar 

  43. Konturek PC, Sliwowski Z, Koziel J, Ptak-Belowska A, Burnat G, Brzozowski T, Konturek SJ (2009) Probiotic bacteria E. coli Nissle 1917 attenuates acute gastric lesion induced by stress. J Physiol Pharmacol 60(Suppl 6):41–48

    CAS  Google Scholar 

  44. Wallace JL (2012) Hydrogen sulphide: a rescue molecule for mucosal defence and repair. Dig Dis Sci 57(6):1432–1434

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Second Department of Internal Medicine, Thuringia Clinic Saalfeld, Rainweg 68, Saalfeld/Saale, 07318, Germany

    Peter C. Konturek

  2. Institute of Physiology, Jagiellonian University Cracow, Grzegorzecka Str. 16, Krakow, 31-525, Poland

    Stanislaw J. Konturek

Authors
  1. Peter C. Konturek
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  2. Stanislaw J. Konturek
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Correspondence to Peter C. Konturek .

Editor information

Editors and Affiliations

  1. Institute of Metabolic Physiology, German Diabetes Center, Heinrich Heine University Düsseldorf, Düsseldorf, Germany

    Eckhard Lammert

  2. CardioMetabolic Diseases Research, Boehringer Ingelheim Pharma GmbH & Co KG, Biberach, Germany

    Martin Zeeb

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Konturek, P.C., Konturek, S.J. (2014). Peptic Ulcer Disease. In: Lammert, E., Zeeb, M. (eds) Metabolism of Human Diseases. Springer, Vienna. https://doi.org/10.1007/978-3-7091-0715-7_21

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