Stress Ulceration What causes it?

Ulceration is caused by ischemic injury to the gastric mucosa, loss of cytoprotectants and assault by gastric acid.

The mucosa is injured and cannot repair itself sufficiently well to ward off aggressive factors present in the gut lumen: these aggressors include gastric acid, bile and digestive enzymes. Mucosal blood flow is diminished, and there is an imbalance of demand for and supply of oxygen. The result is reduced production of cytoprotectant factors, such as prostaglandins, mucosal atrophy and increased permealility, loss of reparative capacity and loss of ability to neutralize acid (hydrogen ions).

The mucosa is compromised by ischemia and attacked (mostly) by acid. It is injured, and, due to the presence of acid, cannot repair itself (hostile environment). The use of external agents to neutralize acid resolves this problem.

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