stresszfekélyek

Stresszfekélyek, often referred to as stress ulcers, are superficial erosions or lesions that can develop in the lining of the stomach or duodenum. While the name suggests a direct link to psychological stress, the term is somewhat misleading. These ulcers are more commonly associated with physiological stress rather than mental stress. Physiological stress in this context refers to severe illness, trauma, or injury that can overwhelm the body's normal protective mechanisms.

Conditions that can precipitate the development of stress ulcers include major surgery, severe burns, sepsis, multiple organ failure, and prolonged mechanical ventilation. The exact pathophysiology is complex but generally involves a combination of factors. A significant reduction in blood flow to the stomach lining (ischemia) is a primary contributor, as it deprives the cells of oxygen and nutrients. This ischemia can be caused by decreased cardiac output, increased sympathetic nervous system activity, or the use of certain medications like non-steroidal anti-inflammatory drugs (NSAIDs).

The compromised blood flow impairs the stomach's ability to produce protective mucus and bicarbonate, which normally neutralize stomach acid. The resulting imbalance between aggressive factors (acid, pepsin) and protective factors leads to damage of the mucosal lining. Unlike peptic ulcers caused by Helicobacter pylori infection or NSAID use, stress ulcers are often multiple, superficial, and found in the body of the stomach. They can range from small erosions to deeper ulcerations, and while often asymptomatic, they can lead to serious complications such as gastrointestinal bleeding. Diagnosis is typically made through upper endoscopy. Management focuses on preventing these complications through stress ulcer prophylaxis, usually involving acid-suppressing medications like proton pump inhibitors or H2 receptor antagonists, and addressing the underlying critical illness.