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Zhou Xiao-Han
ABOUT PEPTIC
ULCER
Peptic ulcers are common,
and
comprise about
10-12% of
all
popula-
tion.
At one time during
their
lives, ap-
proximately one
in
5 (male)
or
10 (fe-
male)
persons
probably sufier
from pep-
tic ulcer. A
rational understanding of
the pathophysiology of peptic ulcer
is
important to every one from young to
old.
However,
it
requires
a
sound
knowledge of
the
normal mechanisms
which control the function of
the
stom-
ach.
The gastric mucosa
is
remarkably
resistant to
injury.
Two factors normally
protect the stomach from autodigestion
by gastric
acids:
1) gastric mucus and
2) the epithelial
barrier.
ln
the devel-
opment
of
either duodenal
or
gastric
ulcer
in
a given patient,
it
is likely
a
multiplicity
of
causative
and
contribut-
ing factors
are involved. The
rnost
re-
cent data have suggested that
a
kind
of
bacteria
Helicobacter
pylori
(Hp)
in-
fection may be striking in most of
the
patients with peptic ulcer.
Virtually every conceivable
di-
etary regimen
or drug
therapy
has
been
advocated
at
one
time or
another.
Rather
than
uniformly imposing an ex-
tremely restrictive dietary and pharma-
cological regimen, each patient can be
treated
in
a manner most suitable
lor
him
without significant altering
the
inci-
dence
of
recurrence or complications.
However, Hp eradication therapy
has
most recently been advocated
as
the
etfective regimen for ulcer healing and
recurrence
prevention.
The indications
for surgical treatment are only applica-
ble
to
patients with
complications
of the disease such as perforation, ob-
struction, intractable
bleeding
and
ref
ractoriness to medical therapy.
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67
