duodenal ulcer gastric ulcer

A peptic ulcer, also known as PUD or peptic ulcer disease,^[1] is the most commonulcer of an area of the gastrointestinal tract that is usually acidic and thus extremely painful. It is defined as mucosal erosions equal to or greater than 0.5 cm. As many as 70–90% of such ulcers are associated with Helicobacter pylori, a spiral-shaped bacterium that lives in the acidic environment of the stomach; however, only 40% of those cases go to a doctor. Ulcers can also be caused or worsened by drugs such asaspirin, ibuprofen, and other NSAIDs.^[2]

Four times as many peptic ulcers arise in the duodenum—the first part of the small intestine, just after the stomach—as in the stomach itself. About 4% of gastric ulcers are caused by a malignant tumor, so multiple biopsies are needed to exclude cancer. Duodenal ulcers are generally benign.

胃及十二指腸潰瘍是指胃壁、幽門或十二指腸發生潰瘍病變。

潰瘍多為單個，病發於胃時稱為胃潰瘍（gastric ulcer），出現在十二指腸則稱十二指腸潰瘍（duodenal ulcer）。

臨床特點為慢性、周期性的上腹疼痛，胃潰瘍的痛多發生在進食後半小時至一小時，胃酸增多或正常；十二指腸潰瘍的痛則多出現於食後三至四小時，胃酸一般顯著增多。

輕微者有反胃、嘔吐、疼痛等症狀，嚴重者可因消化道大量出血（嘔血或便血）導致休克。

1981年兩位澳洲醫師巴裡·馬歇爾（Barry J. Marshall）和羅賓·沃倫（Robin Warren）發現幽門螺旋桿菌才是造成胃潰瘍病因，而非過去熟知的壓力或生活不正常等因素。這些病菌進入體內之後，寄生在胃和十二指腸的保護黏膜內，削弱黏膜層的保護作用。為了證實胃潰瘍因細菌而起，馬歇爾喝下含幽門桿菌的飲料，結果導致嚴重胃潰瘍。不久就治好了。

這個重大發現使得人類重新認識潰瘍病成因，使患者真正獲得有效治療。發現者因此獲2005年諾貝爾醫學獎。