5.3.2 Peptic Ulcers
Ulcers caused by the damaging action of gastric，or peptic juices on the lining of the gastrointestinal tract are termed peptic ulcers.Most peptic ulcers appear in the stomach and proximal duodenum.They may involve the lower esophagus，distal duodenum，or jejunum.Ulcers may lead to hemorrhage or perforation of the digestive tract wall.Clinical manifestations of a peptic ulcer include some or all of the following：gnawing epigastric pain，heartburn or indigestion，nausea and vomiting，and bloated feeling after eating.
The origins of such ulcers are not completely known，although infection with bacteria，Helicobacter pylori，has been identified as a major cause.Heredity and stress as well as chronic inflammation and exposure to damaging drugs，such as aspirin，or to irritants in food and drink may be factors.
Diagnosis is based on the client’s history，upper GIbarium studies，and endoscopy.Today，testing for Helicobacter pylori is recommended in all patients with peptic ulcer disease.Endoscopy may also be required in some patients to confirm the diagnosis.
Current treatment includes the administration of antibiotics to eliminate H.pylori infection and use of drugs that block the action of histamine，which stimulates gastric secretion.Normally，most patients can be managed with a proton pump inhibitor（PPI）-based triple-drug therapy.Surgical treatment is indicated if the patient is unresponsive to medical treatment，noncompliant，or at high risk of complications or if an ulcer invades to the point of creating a hole through the complete depth of the stomach or duodenum（perforating ulcer）.
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Task 4 Decide whether the following statements are true（T）or false（F）according to the text.(https://www.daowen.com)
1.Peptic ulcers commonly develop in the stomach，and（or）distal duodenum.（ ）
2.Viral infection，genetics and stress are the major causes of gastric ulcer.（ ）
3.Patients with peptic ulcer may complain of heartburn，gastric distension，nausea，and postprandial bloating.（ ）
4.A patient with peptic ulcer who fails to respond to medical treatment might need surgical treatment.（ ）
5.The anti-inflammatory and anti-histamine medicines are recommended for treating peptic ulcers.（ ）