Evaluation and Management: Recurrent Peptic Ulcer Disease

Abstract

Recurrent or refractory peptic ulcer disease has become increasingly rare as antacid therapy continues to increase and improve with time. Once regarded as a surgical disease, it has now become primarily managed medically and has etiologies ranging from viral, bacterial, comorbid conditions, medication side effects, and lifestyle choices. When traditional therapy fails and symptoms persist, repeat endoscopic evaluation in addition to identification of less common causes of recurrent or refractory peptic ulcer disease should be pursued. We have identified some of these less common and sometimes rarely studied etiologies to give the reader a full understanding of what the possibilities are worldwide. This chapter provides the reader with a framework to not only identify the often elusive etiologies but also treatment options to better assist with the management of this increasingly rare disease.