PATHOGENESIS OF GASTRIC-ULCER

The cause of gastric ulcer is still poorly understood, even though a c ertain number of pathophysiologic abnormalities have been described in subgroups of gastric ulcer patients. It is not known whether these ab normalities lead to ulceration or occur as a result of ulcers. Environ mental factors, such as aspirin intake or stressful life events, may b e related to gastric ulcer in some patients. The main pathophysiologic events (dismotility, prostaglandin formation, alteration in gastric m ucosal barrier and blood flow, impaired gastric secretions), and the e nvironmental factors involved in the development of gastric ulcer (cig arette smoking, alcohol consumption, drug ingestion, psychologic stres s, infectious agents) are reviewed in this paper. Knowledge about the natural history of gastric ulcer has been increased by the availabilit y of fiberoptic endoscopy and by controlled clinical trials, but ulcer pathogenesis still remains obscure, and perhaps multifactorial.