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Peptic Ulcer

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Peptic Ulcers and Its Treatment

Introduction
Peptic ulcers are open sores that develop in the stomach lining. It is also develop in the lining of duodenum, or esophagus as a result of erosion that formed by acidic digestive juices which corroding the lining of the digestive system. There are three types of peptic ulcers, which are gastric ulcers, duodenal ulcers and esophageal ulcers. Gastric ulcers are ulcers that develop inside the stomach. Duodenal ulcers are ulcers that develop in the upper portion of the small intestine, called duodenum. Esophageal ulcers are ulcers that develop inside the esophagus.
The etiology of peptic ulcer is not clearly known. Infection of stomach with the bacterium Helicobacter pylori or use of certain drugs such as nonsteroidal anti-inflammatory drugs (NSAIDs) is contributed to ulcer formation. In gastric ulcer, the acid secretion is normal or low. Generally acid secretion is high or normal in duodenal ulcer. The treatment of peptic ulcer is divided into 4 classes: agents that reduce gastric acid secretion, agents that neutralize gastric acid, agents that promote mucosal defense and anti-H. pylori drugs.

Treatment
Pharmacological measures for the management of peptic ulcers
1. Reduction of gastric acid secretion
Histamine (H2) receptor antagonists
Example: cimetidine, nizatidine, ranitidine, and famotidine
They are highly selective H2 receptor antagonists. They work by binding to H2 receptors which are located on the basolateral membrane of the parietal cell and suppress basal and meal-stimulated acid secretion. This competitive inhibition results in reducing the pepsin concentration and the volume of gastric secretion. Secretion of gastric acid are stimulated by histamine, gastrin and cholinomimetic agents. H2 receptor antagonists reduce the gastric acid secretion through two mechanisms. First, they block the binding

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