Etiology:
1. Genetic and blood groups: Blood group O three times common than other groups.
2. Neurogenic: stress and anxiety through Vagus nerve.
3. Endocrine: There are specific endocrine disorders which may be associated with severe or intractable ulceration.
a) Zollinger - ellison syndrome.
b) Multiple adenoma syndrome.
c) Hyperparathyroidism.
4. Infection: Helicobacter Pylori.
5. Accessory causes: inadequate mastications, alcohol, irregular meals, smoking, vitamin deficiency.
Pathology:
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Occurs in alkaline mucosa.
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Invades muscle coats.
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Fibrosis from recurrent ulcers causes deformities.
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Nearly always situated in first part.
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Anterior ulcer carries risk of perforation while posterior ulcer may cause hemorrhage due to erosion of gastroduodenal artery.
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