Attenuated Gastric Mucosal Blood Flow Predicts Non-Healing of Benign Gastric Ulcers

Abstract

Background: A subset of benign gastric ulcers do not respond to therapy and may require surgery. A predictor of non-healing may allow modification of therapy. Gastric mucosal blood flow plays an important role in gastric ulcer pathogenesis and healing. Aims: Mucosal blood flow was measured with Laser Doppler flowmetry at initiation of and during therapy to assess the variability of mucosal blood flow in healing and non-healing ulcers as a possible predictor of healing. Methods and Subjects: Mucosal blood flow was measured at the mid-antrum in 105 normal human stomachs and on the circumference of 26 benign gastric ulcers. The gastric ulcers were followed up with repeat endoscopy and repeat measurements were made. Results: The ulcers that healed had significantly higher mucosal blood flow than normal stomachs at both initial and follow-up measurement (59.8 ± 26.1 vs. 75.7 ± 17.5 and 69.8 ± 13.7). The refractory ulcers persistently had significantly lower mucosal blood flow than normal stomachs and healing ulcers (59.8 ± 26.1 vs. 45.2 ± 21.9 and 39.2 ± 6.7). Conclusions: Gastric mucosal blood flow seems to increase in response to mucosal injury and healing. Attenuation of this response is associated with delayed healing. Attenuated peri-ulcer mucosal blood flow may predict non-healing of a benign gastric ulcer.