Gastric and Duodenal Ulcers

Duodenal ulcers are two to three times more common than gastric ulcers. Gastric ulcers are most frequent among those aged 40-70 years, whereas duodenal ulcers are most commonly seen between the age of 25 and 55 years. Thus, complications in gastric ulcers tend to be more severe because they tend to affect older individuals. Ulcer rates are declining rapidly for younger men and increasing for older individuals.

Acid secretion patterns differ with the location of the ulcer. Duodenal ulcers are associated with high-acid secretion while proximal gastric ulcers are associated with a low-acid output. Distal gastric ulcers can have a normal- or high-acid output. The difference in acid output is a reflection of the effects of inflammation on the underlying cell types. Inflammation of the antrum and the body is much more pronounced in gastric ulcer than in duodenal ulcer. In addition, there is usually a progression of inflammation in gastric ulcers. As a result, this could eventually lead to hyposecretion of acid from glands in the fundus.

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