Pathogenesis and therapy of gastric and duodenal ulcer disease.
Despite the decreasing frequency of Helicobacter pylori-induced peptic ulcers, peptic ulcer disease remains a major clinical problem partly because nonsteroidal anti-inflammatory drug ulcers have increased in frequency. The reduction in nonsteroidal anti-inflammatory drug ulcers by use of selective cyclooxygenase-2 inhibitors will not eliminate the problem because of increased use of aspirin for cardiovascular prophylaxis. This article reviews current concepts of peptic ulcer pathogenesis and therapy according to ulcer etiology; discusses potential interactions between etiologies; and considers the therapy for H pylori infection including the effects of antimicrobial resistance, and the role of bismuth quadruple therapy or furazolidone salvage therapy.
Shiotani
Akiko
A
Health Administration Center, Wakayama University, Wakayama City 640-8510, Japan.
Graham
David Y
DY
D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D004381:Duodenal Ulcer / Q000139:chemically induced / Q000209:etiology* / Q000382:microbiology / Q000628:therapy*; D016481:Helicobacter Infections / Q000175:diagnosis / Q000188:drug therapy; D016480:Helicobacter pylori; D006801:Humans; D013276:Stomach Ulcer / Q000139:chemically induced / Q000209:etiology* / Q000382:microbiology / Q000628:therapy*
D000894:Anti-Inflammatory Agents, Non-Steroidal