What are the Key Characteristics of Gastric Ulcer Pathology?

Gastric ulcer is a common gastric disease that typically manifests with significant abdominal pain, predominantly affecting middle-aged and elderly individuals. However, due to improper dietary habits, the patient population is showing a trend of younger age groups. Once gastric ulcer is detected, timely and effective treatment is essential to prevent any potential harm. Nevertheless, some individuals lack a thorough understanding of the characteristics of gastric ulcer. In the following, we will briefly outline the characteristics of gastric ulcer to enhance everyone's knowledge of this disease.

The characteristics of gastric ulcer lesions include small, round or elliptical ulcers with neat edges and flat bottoms. The ulcer base is divided into four layers: inflammatory exudate, necrosis, granulation tissue, and scar tissue. Patients with gastric ulcer typically experience pain primarily one hour after meals, which gradually resolves over 1-2 hours and recurs after the next meal, commonly referred to as postprandial pain, one of the most common symptoms of gastric ulcer.

Gastric perforation is the most severe complication. Typically, the damage caused by gastric ulcer occurs in the mucosal muscular layer of the gastrointestinal tract. When the ulcer persists to a certain extent, it can lead to acute gastrointestinal perforation. If gastric perforation occurs, the contents of the intestine can flow into the abdominal cavity, leading to acute diffuse peritonitis, posing a potential life-threatening risk.

Bleeding can occur when the gastric ulcer progresses to a certain extent and erodes the surrounding blood vessels, causing vessel rupture. The degree of bleeding determines the severity of the harm to the patient's body. Canceration is a potential outcome of gastric ulcer deterioration, although there is significant controversy regarding whether chronic gastric ulcer can lead to cancer. Most people believe that canceration is a possibility, with an estimated risk of approximately 1%.

There are four main types of drugs used to treat gastric ulcer:

1. H2 receptor antagonists are crucial drugs for treating peptic ulcers. They specifically antagonize the h2 receptors of gastric parietal cells, blocking the secretion of gastric acid caused by histamine or histamine receptor agonists. Common drugs include cimetidine, ranitidine, famotidine, nizatidine, and roxatidine, primarily used to treat gastric and duodenal ulcers.
2. Proton pump inhibitors are drugs that inhibit gastric acid secretion by blocking the activity of the H+ pump in parietal cells. A common example is omeprazole, which is concentrated around the secretory canaliculi of parietal cells after oral administration, converting into active sulfinamide derivatives that bind to corresponding enzymes to deactivate the H+ pump and reduce gastric acid secretion.
3. M1 cholinergic receptor antagonists selectively antagonize the M1 cholinergic receptors of parietal cells to inhibit gastric acid secretion, with low affinity for other M cholinergic receptors and relatively mild adverse effects. Common drugs include pirenzepine and telenzepine, primarily used to relieve pain caused by duodenal and gastric ulcers.
4. Gastrin receptor antagonists have a similar structure to gastrin and competitively antagonize gastrin receptors, effectively reducing gastric acid secretion and protecting and promoting the healing of the gastric mucosa. A common drug is proglumide.

In conclusion, gastric ulcer is a severe disease that requires timely and effective treatment to prevent potential harm. It is essential to maintain a healthy lifestyle, including regular exercise and enhancing resistance to disease, to prevent gastric ulcer and safeguard one's physical health.