SCHEMATIC PATHOPHYSIOLOGY

Contributing Factor: Precipitating Factors:

 Diet: Excessive caffeine intake  Age: 50-70 years old

 Increase hydrochloric acid (HCL) production
 Excessive alcohol intake
 Low socioeconomic status
 Smoking
 Unclean foods and water
 Stress factors  Unsanitary living condition
 Type “0” blood  Irritation to the lining of (mucosal), proximal
 Genetic predisposition of small intestines
 Gastric acid secretion  Presence of Helicobacter Pylori infection
 Ulcerogenic substances (NSAID’s e.g aspirin,
ibuprofen)

Excessive production of Entry of H.pylori through

Excessive NSAID use
Hydrochloric acid (HCL) ingestion

Irritation of the lining Renders the mucosa Toxicity to gastric

(mucosal) of the stomach, more vulnerable to acid COX-1 inhibition epithelial cell
duodenum, proximal of damage by disrupting
small intestines mucous layer, liberating
enzymes and adhering to
gastric epithelium.

Decreased
Imbalances between prostaglandins
protective mechanisms
Altered gastric
and the acid-pepsin
secretion
proteolytic enzymes

Decreased gastric
Tissue injury in the mucous production
stomach/ Ulcers

Can damage mucosal barrier

Can cause activation of inflammatory process

  Decreased function of mucosal cells
 Decreased quality of mucus
 Loss of tight junction between cells

Back diffusion of acid into gastric mucosa

Conversion of pepsinogen to Increased acid Formation of liberation of

pepsin secretion histamine

 Further mucosal erosion Local vasodilation

 Destruction of blood Stimulation of cholinergic
intramural plexus, causing muscle
spasm

Ulceration Epigastric pain  Increased capillary permeability

 Loss of plasma proteins
 Mucosal edema
Bleeding in Bleeding in  Loss of plasma into gastric lumen
Dyspepisia
esophagus stomach

Excessive
bleeding
Hematemesis (hemorrhage)
(Vomiting of
blood)
Blood passes through GI
Decreased oxygen tract becomes oxidized by
carrying capacity as HCl resulting in
manifested by
Blood gets decreased hgb and *Black tarry stool Pyloric
oxidized by hct level obstruction
HCl but
moves back
to esophagus
 Pallor
 Lightheadedness
Coffee-ground  Weakness
emesis