Peptic Ulcer Disease: Retrospection on History, Pathophysiology its Mainstream and Herbal Drug Therapy

Abstract

Peptic ulcer, a persistent condition affecting approximately 10% of the global population, arises due to factors such as gastric juice pH and a decline in mucosal defenses. The primary causes of mucosal resistance disruption leading to peptic ulcers are attributed to the use of NSAIDs and Helicobacter pylori (H. pylori) infection. Despite traditional treatments such as proton pump inhibitors (PPIs) and histamine-2 (H2) receptor antagonists, limitations like adverse effects, relapses, and potential drug interactions have been observed. The main objective of antiulcer therapy is to either prevent acid secretion from gastric parietal cells or neutralize the acid before it reaches ulcerated areas in the gastrointestinal tract. Conventional approaches for duodenal ulcers, including diet, antacids, and anticholinergics, have been in practice for an extended period. However, only antacids have been definitively proven effective for healing, albeit requiring administration in large and frequent doses. Addressing the pathophysiology and optimal treatment strategies for non-NSAID, non-H. pylori associated peptic ulcers remains challenging. The review underscores the H. pylori infection and NSAID use as the most prevalent risk factors for ulcer development. Additionally, genetic predisposition, stress, and comorbidities elevate the risk of ulcer occurrence. Successful eradication and prevention of these risk factors are crucial to averting the presence of ulcers and their complications. Conversely, medicinal plants and their chemical compounds emerge as valuable in preventing and treating various diseases. Consequently, the review provides insights into the etiology, pathogenesis, chemotherapy, and common medicinal plants that may be employed in the treatment or prevention of peptic ulcers.