Peptic ulcer disease: current notions

Abstract

Helicobacter pylori infection and non-steroidal anti-inflammatory drugs (NSAIDs) are the two most important aetiological factors inpepticulcerdisease (PUD).Whilehostgenetic factors and dietary factors might also play a role, to date there is insufficientdata to implicate these in theaetiologyof PUD. A range of H. pylori virulence factors, including the cytotoxin associated geneA and the vacuolating cytotoxin A, have been linkedwith both increased levels of inflammation and PUD. A further virulence factor known as the duodenalulcer promoting geneAhas been specifically associatedwith an increased risk of PUD worldwide. Although increasing reports of H. pylori negative PUD has led some to question the role of H. pylori in PUD, investigations of this issue suggest that H. pylori negative PUDs are mainly due to NSAIDs usage and to false negative results related to diagnostic methods.