Attenuated gastric mucosal blood flow predicts non-healing of benign gastric ulcers.
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.


OBJECTIVE
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
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.
Clarke
D L
DL
Department of General Surgery, Nelson R Mandela School of Medicine, University of Natal, Durban, South Africa.
Thomson
S R
SR
D000328:Adult; D000368:Aged; D005260:Female; D005753:Gastric Mucosa / Q000098:blood supply* / Q000502:physiology*; D006801:Humans; D017078:Laser-Doppler Flowmetry; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D013276:Stomach Ulcer / Q000175:diagnosis* / Q000503:physiopathology*; D014945:Wound Healing / Q000502:physiology*