ALCOH

DRUG: Stress
SMOKI
NSAID
Nicotin
stimulan
Inhibits COX1 &
vasoconstricti mucosal blood flow and
COX2
on ↑parasympathe motility
Blocks
tic nerve
Prostaglandin
Blood activity to the Stasis of chyme and
synthesis
supply ↑glucocorticoid
Mucin Secretion, HCO3 H-
effects
Interferes with the rapid pylori
secretion, Surface active
Colonizes antral
regeneration of epithelium , Antibiotic,
phospholipid secretion,
proton
production of mucus, secretion
Epithelial cell proliferation, pump Secretes cytotoxins
of alkaline bicarbonate ion, inhibitor, and enzymes
secretion of protective bismuth
protease,
salts
phospholipase, and
↑Stimulation to
enterochromaffi Relaease of
Acid &
n-like cells and pepsin
g-cells

Damage to
mucosal
defenses and

ea

ea
Ur
br
th
te
st
Imbalanced
aggressive
and defensive

↓mucosal cells, H2 receptor

↓quality of mucous, antagonist, proton
pump inhibitor
↓tight junction
between cells
 Infection
Allowing Healing
↑gastrin
chyme to enter with
and↓somatosta
osco

peritoneal
End

tin production
py

cavity
Erosion to Perforati
Peritonitis/ Dislodgement of
the lining on
inflammation of the scar tissue
of the
peritoneal membrane around the
stomach
and other structure of duodenum or
Erosion of Ulcer may Rupture of abdominal cavity
large blood erode to small blood
blood ↑permeability of Obstruction of
intestinal wall, passage the digestive
Massive Occult blood of bacteria and their tract
Hemorrhage Hemorrha in stool toxins into the peritoneal
ge cavity and bacterial
Hemateme Iron-
sis, shock, deficiency

Blood

Occul
Test,

Fecal
antig
stool
test
en

t
Could not secrete Billroth I
Gastroduodenosco
enough mucus to
Severe py
act as a protection • Epigastric
ulcerations/pep
tic ulcer pain

Resistant to • Hematemesis
Zollinger-
standard
Ellison • Dyspepsia
medical
syndrome
therapy
(gastrinoma) • Pyrosis