82 year-old woman with protracted nausea, and occult gastrointestinal bleeding. Duodenal ulcers are associated with chronic superficial gastritis in the gastric antrum. The hypothesized route of development of duodenal ulcers is shown in Figure 1 as adapted from Hunt. This proposed method involves an increase in gastrin release caused by H. pylori infection. The increased gastrin level causes increased acid delivery to the duodenum.
Ulceration can result from the increased levels of acid.
Eradication of the bacterium from a person greatly reduces the recurrence of ulcers. Endoscopy demonstrating two large ulcers in the duodenal bulb, with surrounding duodenitis. There is increased prevalence of H. pylori association with gastric cancer. There is a known stepwise progression from chronic superficial gastritis to intestinal type cancer. It is estimated that H. pylori infection increases the risk of gastric cancer 6 times.