Which factor(s) contribute(s) to the development of PUD? (Select all that apply.)
a. Cigarette smoking
b. Stress
c. Genetics
d. Excessive ingestion of milk products
e. H. pylori
ANS: A, C, E
Cigarette smoking increases acid secretion and alters blood flow to the stomach. In addition, cigarette smoking interferes with prostaglandin synthesis, which compromises defense mechanisms. A genetic predisposition seems to exist for the development of PUD. Infection by H. pylori is thought to be associated with as many as 90% of duodenal and 70% of gastric ulcers. Chronic emotional stress was previously believed to cause stress ulcers, and physicians suggested that patients with this condition reduce their stress levels. However, patients who took steps to reduce the stress in their lives saw no improvement. It is now known that emotional stress does not cause ulcers, but it may make them worse. Bacteria have been shown to cause a stress ulcer, which can be treated simply by taking a dose of antibiotics. Dairy products do not contribute to the development of ulcers.
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