Medical Treatment Of Duodenal Ulcer Research Articles

Medical treatment of duodenal ulcer: Acid inhibition or Helicobacter pylori eradication?

To ascertain whether acid inhibition or Helicobacter pylori (HP) colonization is the decisive factor in the healing of duodenal ulcer, we treated 54 patients with famotidine and carried out long-term follow-up. Helicobacter pylori colonization was found in 70.4% of patients before treatment. There were no differences in the pre-treatment characteristics between patients with HP positive or HP negative ulcers. The 4-week and 8-week healing rates after famotidine treatment were 72.5% and 82.4% respectively. No difference in HP colonization was found between patients with ulcer healed and those with ulcer not healed (78.4% vs 64.3% at 4th week and 77.3% vs 71.4% at 8th week, P greater than 0.05). In patients with ulcer healed at 4th week, the intragastric pH was raised significantly and the antral acute inflammation was less severe than those with ulcer not healed. Ulcer recurrence was found in 76.9% of patients within 1 year, but there was no difference in ulcer recurrence between the patients with positive or negative HP colonization at the time of ulcer healing. Our results suggest that duodenal ulcer healing and recurrence are closely related to acid inhibition rather than to HP colonization.

Pyloric stenosis complicating duodenal ulceration.

AbstractPyloric stenosis would be better termed gastric outlet obstruction but popular usage favors the former title. The most common cause in adults is a stenosing chronic duodenal ulcer, but differential diagnosis must be made clinically, radiologically, and endoscopically from other causes, particularly carcinoma of the gastric antrum. Metabolic disturbances due to fluid and electrolyte loss are not common but, if present, require correction by intravenous replacement therapy.The condition is becoming less common due to the overall decline in incidence of duodenal ulcer in the Western world and the more effective medical treatment of duodenal ulcer with H2antagonists. It is still common, however, in many parts of the Third World.Treatment is invariably surgical but medical preoperative preparation is required. Vagotomy combined with drainage gives excellent results.

Current Concepts in the Medical Treatment of Duodenal Ulcer

While the medical treatment of duodenal ulcer is often effective, it is still difficult to validate physiologically. Current medical therapy remains empiric, with primary emphasis on reduction of acid and peptic activity of gastric and duodenal contents. Antacids, antisecretory drugs, pepsin inhibitors, and carbenoxolone sodium are among the agents discussed.

The Medical Treatment of Duodenal Ulcer

The Medical Treatment of Duodenal Ulcer

PREVENTION OF RECURRENCES IN PEPTIC ULCER

Excerpt The thoughtful internist has reason to be dissatisfied with the present handling of the problem of peptic ulcer. Statistically peptic ulcer occupies twentieth place in the prevalence of chr...

THE SURGICAL TREATMENT OF ULCERATIVE COLITIS

I am sure every surgeon wishes that the entire problem of ulcerative colitis might be taken from his domain. In the distant past, unfamiliarity with the pathology of this condition was undoubtedly responsible for the very poor results which many surgeons had and certainly this stimulated many investigators to perfect a medical management which would take the place of surgical intervention. In this regard, however, I think the pendulum has swung a little too far. We all remember the time, not so long ago, when pitched battles were fought relative to surgical versus medical treatment of duodenal ulcer. While neither is entirely satisfactory, it is now well recognized that both medicine and surgery have a definite place in the management of ulcer and the indications for each have come to be fairly well established. So it is with ulcerative colitis. The surgeon and the medical man must learn to speak

Factors influencing prognosis in the medical treatment of duodenal ulcer

LTHOUGH statistics on the resuIts A as successfu1 are definiteIy known to have of treatment of duodena1 uIcer are had a remission extending over the number difficuIt to compiIe and more diffIof years indicated, we beIieve that if there cuIt to interpret, it has been our experience is any error in our figures it is towards that of a11 cases treated medicaIIy nearIy making the percentage of recurrences too one haIf, or 46 per cent, may be expected high rather than too Iow. to have one or more recurrences within Our method of management in a11 cases five years. reported here has consisted of neutraIizaTabIe I indicates that the incidence of tion methods (Sippy) with the patients in recurrences is g per cent at the end of the bed in the hospita1 for about three weeks.

Medical Treatment of Duodenal Ulcer

Medical Treatment of Duodenal Ulcer

THE MEDICAL TREATMENT OF DUODENAL AND GASTRIC ULCER.

To write a short discussion on the medical treatment of duodenal and gastric ulcer would have been a relatively simple task a few years ago; to-day it is far different and by no means easily performed. The difficulty arises in some degree because we realize more clearly than formerly that the course and prognosis of acute ulcer differ greatly from those of chronic ulcer, and especially because surgery has in a few years made such advances in the treatment of gastric ulcer that we must consider when medical treatment will suffice or when it is necessary for a surgeon to consider jointly what method of treatment will give the quickest and most permanent relief to the patient. The medical treatment of duodenal ulcer being practically the same as for gastric ulcer, what is said for one will apply also for the other. The acute and chronic gastric ulcer can not