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H. pylori, Smoking=nicotine, NSAID - Coggle Diagram

- - - - Cag A distrupt cell tight junction -> IL8 produced -> Inflammation
        
        imbalance of protective and aggressive factors -> ulcer development (lesion that extend to the submucosa & muscularis propria)
        
        acid irritation to exposed nerve
        
        Pain (burning and sharp, relieved if eating as it provide temporarily buffer or pain when eating - gastric. 2-3 h pain post prandial if duodenum due closed sphincter)
        
        Slow bleeding if the ulcers erode the blood vessel (@muscularis propria)
        
        coffee like appearance due to blood oxidized by gastric acid (iron=toxic or bacterial toxins)
        
        ECL cell release 5HT that activate the 5HT vagal afferent nerve -> CTZ -> VC -> hematemesis
      - Vac A bind to mitochondrial membrane -> leakage of cytochrome c -> apoptosis
- - - - ⬇️HCO3-
      - ⬇️Healing of epithelial cell