The gastric mucosal barrier is the

property of the stomach that allows it to

contain acid

If the barrier is broken , then the acid

diffuses back into the mucosa and

damage the stomach wall

The gastric mucosal barrier is made up of

3 components

compact epithelial cell lining with tight

junctions

Gastric mucus covering(gel like coating )

Bicarbonate ions, secreted by the

surface epithelial cells. The bicarbonate

ions act to neutralize harsh acids

Mucus is secreted by mucus cells

Present allover the GIT

Acts as a protectant and lubricant of

wall of gut

Mucus is a viscous gel which contains

mucin, phospholipids, electrolytes

(mainly HCO3 )and water

Separates the epithelial cells from acid

of stomach

This maintains the Ph of epithelial cells

alkaline despite gastric acid

Mucus is strongly resistant to digestion by

gastric enzymes

Has buffering properties( neutralize acid )

Helps in propulsive movement by

lubrication

Easy slippage of food

Ulcer :- An Ulcer is a discontinuity or

break in a bodily membrane ,or breach

in the epithelium

Ulcer and occur anywhere in the body

When it occurs in stomach its gastric

ulcer

In duodenum its duodenal ulcer

Ulcer occurring in either of these two

sites is called peptic ulcer

Its also known as acid peptic disease

Defect in the mucosal barrier

Hyper secretion of acid

Helicobacter bacterial infection

If the secretion of mucus is impaired

Or bicarbonate production is impaired

Such damage is caused by drugs like

asprin, NSAID

Chronic stress conditions (stress ulcer )

Chronic anxiety

Common in people with busy life style

Hurry , worry , curry

Intake of spicy food –leads to

hyperchlorhydria

Conditions with hyperchlorhydria

(Zollinger ellison syndrome ) gastrin

secreting tumor

Major cause of peptic ulcer

This bacterial infection causes

Damage to the mucosal barrier

Increase in gastrin secretion from G cells

Reduce somatostatin from D cells

Initially causes gastritis which later on

leads to peptic ulcer

Upper abdominal pain

Pain usually by empty stomach relieved

by food or antacid

Vomiting

Blood vomiting and perforation in severe

cases

Acetylcholine

Gastrin

Histamine

Anti histamines

Anticholinergic drugs

Proton pump blockers

Sucralfate

Gastrin blockers

Antacids

Avoid stress

Adequate sleep

Regulation of diet

Avoid spicy foods , alcohol

Withdrawal of drugs like aspirin, NSAIDS

Vagotomy

Gastrectomy