Peptische

Peptische is a term used in gastroenterology to describe conditions related to peptic activity in the upper digestive tract, most often in reference to peptic ulcer disease and peptic gastritis. The designation derives from the digestion-related factors of the stomach, namely acid and pepsin, and it denotes diseases where mucosal defense and aggressive factors interact to determine mucosal injury.

The most important causes and risk factors include infection with Helicobacter pylori, regular use of nonsteroidal anti-inflammatory drugs (NSAIDs), smoking, and advanced age. Pathophysiology involves an imbalance between mucosal protective mechanisms and injurious factors such as gastric acid and pepsin. H. pylori infection can weaken the mucous layer and elevate acid production, while NSAIDs inhibit prostaglandin synthesis and reduce mucosal defenses.

Clinical presentation typically includes epigastric pain or discomfort. Duodenal ulcers often cause pain several hours after meals and may awaken patients at night, whereas gastric ulcers can worsen with meals. Other symptoms may include nausea, vomiting, weight loss, or signs of gastrointestinal bleeding. Diagnosis relies on clinical assessment, endoscopy with biopsy to exclude cancer, and testing for H. pylori (urea breath test, stool antigen, or biopsies). Blood tests may reveal anemia in cases of bleeding.

Treatment aims to relieve symptoms, heal mucosal injury, and prevent recurrence. This usually involves eradication therapy if H. pylori is present, proton pump inhibitors or other acid-suppressing medications, and avoidance or modification of NSAID use. Additional measures include smoking cessation, careful nutrition, and, in bleeding ulcers, endoscopic hemostasis. With appropriate therapy, many patients experience symptom relief and healing, though recurrence can occur if risk factors persist. See also peptic ulcer disease and gastritis.