2021 Basic knowledge of medical and health medicine: gastric ulcer

"August" 2021 Tianjin Medical and Health Recruitment Announcement | Announcement Summary (Updated Daily)

As the level of internal heat increases, our diet becomes more and more abundant, but as time goes by As a result, more and more digestive system diseases have arisen. And the stomach has endured more accordingly. Is your stomach okay?

Gastric ulcers are becoming more and more common, which has also attracted our attention.

Peptic ulcer disease, also known as peptic ulcer or chronic peptic ulcer, is a common disease characterized by the formation of chronic ulcers in the gastric or duodenal mucosa, and is more common in adults. The disease often relapses and takes a chronic course. Since its occurrence is related to the self-digestion of gastric juice, it is called peptic ulcer disease. Duodenal ulcers are more common than gastric ulcers, with the former accounting for about 70% and the latter accounting for 25%. Compound ulcers coexisting in the stomach and duodenum only account for 5%. Clinically, patients have symptoms such as periodic upper abdominal pain, acid reflux, and belching.

To the naked eye, gastric ulcers are mostly located on the lesser curvature of the stomach. They are more common closer to the pylorus, especially in the gastric antrum. It is rare in the fundus of the stomach and the greater curvature. The ulcer is often one, round or oval in shape, and usually less than 2cm in diameter. The edge of the ulcer is neat, like a knife cut, and the bottom is flat and clean. It usually passes through the submucosa and reaches deep into the muscle layer and even the serosa layer. Due to the peristalsis of the stomach, the cardiac side of the ulcer is usually deeper and its edge is straight and dignified. The pylorus side of the ulcer is shallow and stepped, that is, the layers of the local gastric wall are cut off and exposed in a stepped manner. The gastric mucosal folds around the ulcer are pulled by the scar tissue at the ulcer base and radiate toward the ulcer.

Under the microscope, the bottom of the ulcer is divided into four layers from the inside to the outside: the top layer is a small amount of inflammatory exudate (white blood cells, cellulose, etc.); below it is a layer of necrotic tissue; below it is fresher tissue. The granulation tissue layer; the bottom layer is old scar tissue. Small arteries at the base of scars often suffer from proliferative endoarteritis due to inflammatory stimulation, which thickens the walls of the small arteries, narrows the lumen, and may also be accompanied by thrombosis, which can cause insufficient local blood supply, affect tissue regeneration, and make ulcers difficult to heal. But this change can prevent ulcer blood vessels from rupturing and bleeding. Ganglion cells and nerve fibers at the base of ulcers often undergo degeneration, rupture, and globular proliferation. This change may be one of the causes of pain symptoms in patients. The cross-section of the ulcer is obliquely funnel-shaped and reaches deep into the muscle layer.

Pay attention to your diet and protect your gastrointestinal tract, starting today.

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