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Card 15

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Gastric and Duodenal Ulcers
The neurogenous theory of the pathogenesis of ulcer was developed further into the corticovisceral theory by K. Bykov and I. Kurtsin. According to this theory gastric and duodenal ulcers were found to result from disturbances in the central nervous system, i. e. the brain cortex.
The brain cortex under the influence of external and internal stimuli sends impulses to the stomach and the duodenum, which cause a spastic contraction of vessels. Such a spastic contraction results in local trophic disturbances fol­lowed by erosion of the affected area by the gastric juice.
In the majority of cases ulcer is observed to develop in particularly nervous persons, often after emotional overstrain. But an irregular diet in combination with an emotional overstrain is often observed to contribute to the onset of ulcer development.
Gastric and duodenal ulcers are found to develop more frequently in men than in women, mainly at ages of 25 to 40 years. This disease is characterized by pains, haemorrhages, nausea, vomiting, etc. At the onset of the disease pain is usually dull in character. In gastric ulcers pain is found to grow worse after meals. Acute pain in the stomach is known to be characteristic of perforated ulcers. Pain due to ulcer is well known to occur periodically and be intermittent in occurrence.
The course of ulcer has proved to vary with age and sex, location of ulcers, etc. At a young age its course has no characteristic clinical manifestations. In old persons the incidence of ulcers is known to be rare. But they are often com­plicated by considerable haemorrhage resulting from sclerotic changes in the stomach.

Oshqozon va o'n ikki barmoqli ichak yaralari

Yaraning patogenezining neyrogen nazariyasi K. Bikov va I. Kurtsin tomonidan kortikoviseral nazariyada yanada rivojlandi. Ushbu nazariyaga ko'ra oshqozon va o'n ikki barmoqli ichak yaralari markaziy asab tizimidagi buzilishlar natijasida kelib chiqqan, ya'ni. e. miya korteksi.

Miya korteksi tashqi va ichki stimullar ta'sirida oshqozon va o'n ikki barmoqli ichakka impulslar yuboradi, bu tomirlarning spastik qisqarishini keltirib chiqaradi. Bunday spastik qisqarish natijasida mahalliy trofik buzilishlar, so'ngra oshqozon sharbati ta'sir joyni eroziyasi kuzatiladi.

Aksariyat hollarda oshqozon yarasi ayniqsa asabiy odamlarda, ko'pincha hissiy haddan tashqari kuchlanishdan keyin rivojlanadi. Ammo emotsional haddan tashqari kuchlanish bilan birgalikda tartibsiz ovqatlanish ko'pincha oshqozon yarasi rivojlanishiga hissa qo'shishi kuzatiladi.

Oshqozon va o'n ikki barmoqli ichak yarasi ayollarga qaraganda erkaklarda, asosan 25 yoshdan 40 yoshgacha tez-tez rivojlanib borishi aniqlandi. Ushbu kasallik og'riqlar, qon ketish, ko'ngil aynish, qusish va boshqalar bilan tavsiflanadi. Kasallik boshlanganda og'riq odatda sust xarakterga ega. Oshqozon yarasida og'riq ovqatdan keyin kuchayishi aniqlanadi. Oshqozon ichidagi o'tkir og'riq, teshilgan yaraga xos ekanligi ma'lum. Oshqozon yarasi tufayli og'riq vaqti-vaqti bilan paydo bo'lishi va vaqti-vaqti bilan paydo bo'lishi yaxshi ma'lum.

Yaraning borishi yoshi va jinsi, oshqozon yarasining joylashishi va boshqalarga qarab o'zgarib turdi. Yoshligida uning kechishi o'ziga xos klinik ko'rinishga ega emas. Keksa odamlarda oshqozon yarasi kam uchraydi. Ammo ular ko'pincha oshqozonda sklerotik o'zgarishlar natijasida yuzaga keladigan katta qon ketish bilan murakkablashadi.