title: Deformity of duodenal bulb, gastric metaplasia of duodenal regenerating mucosa and recurrence of duodenal ulcer: a correlated study.
abstract: OBJECTIVE
  To investigate the correlation among the presence and degree of gastric metaplasia of duodenal regenerating mucosa, the deformity of bulb and the recurrence of duodenal ulcer.
  
  
  METHODS
  A total of 99 patients with duodenal ulcer were treated with H(2)-antagonist with or without antimicrobial therapy. All patients received follow-up endoscopic examinations 6 wk after treatment. When the ulcer(s) were noted to be healed, two biopsies were taken from the ulcer scar for histological study of gastric metaplasia, and 4 biopsies were taken from antrum for Helicobacter pylori (H pylori) study. Out of these cases, 44 received further follow-up endoscopic examinations after 3, 6 and 12 mo respectively for studying the recurrence rate of duodenal ulcers. The correlation among ulcer recurrence, degree of gastric metaplasia of regenerating mucosa, bulbar deformity, and colonization of H pylori in the stomach was then studied.
  
  
  RESULTS
  The results showed that there was a strong correlation between the deformity of duodenal bulb and the degree of gastric metaplasia of regenerating duodenal mucosa. The recurrence rate of duodenal ulcer had a significant difference between patients with and without H pylori colonization in the stomach (P<0.001). The greater the degree of gastric metaplasia of duodenal regenerating mucosa, the higher the recurrence rate of duodenal ulcer (P = 0.021). The more deformed the duodenal bulb, the higher the incidence of recurrence of duodenal ulcer (P = 0.03).
  
  
  CONCLUSIONS
  There is a correlation among deformity of duodenal bulb, gastric metaplasia of duodenal regenerating mucosa and recurrence of duodenal ulcer. A more severely deformed duodenal bulb is closely related to a greater extent of gastric metaplasia. Both factors contribute to the recurrence of duodenal ulcer.
authors.affiliation: Department of Internal Medicine, Taipei Medical University Hospital, No 252, Wu-Hsing Street, Taipei 110, Taiwan, China.
authors.forename: Chun-Chao
authors.initials: CC
authors.lastname: Chang
authors.forename: Shiann
authors.initials: S
authors.lastname: Pan
authors.forename: Gi-Shih
authors.initials: GS
authors.lastname: Lien
authors.forename: Cheng-Hsiung
authors.initials: CH
authors.lastname: Liao
authors.forename: Sheng-Hsuan
authors.initials: SH
authors.lastname: Chen
authors.forename: Yeong-Shan
authors.initials: YS
authors.lastname: Cheng
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D004381:Duodenal Ulcer / Q000150:complications / Q000188:drug therapy / Q000473:pathology*; D004386:Duodenum / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D005756:Gastritis / Q000150:complications / Q000473:pathology; D016481:Helicobacter Infections / Q000150:complications / Q000473:pathology; D016480:Helicobacter pylori; D006635:Histamine H2 Antagonists / Q000627:therapeutic use; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology*; D008297:Male; D008679:Metaplasia; D008875:Middle Aged; D012008:Recurrence
chemical_list: D006635:Histamine H2 Antagonists