The medical treatment of peptic ulcer disease.
There is continued interest in the role of H. pylori in both uninvestigated and non ulcer dyspepsia. The literature on this issue provided interesting, if at times conflicting findings, leaving the clinician with little choice but to use clinical judgment when dealing with these patients. On the Therapeutic front, a "new" proton pump inhibitor, with impressive early efficacy data has been launched, while an i.v. proton pump inhibitor formulation has reached a number of markets. Emerging data on the use of potent acid suppression in especially GI bleeding will almost certainly impact on the use of these agents. The gastrointestinal effects of low dose aspirin use have received attention, while the COX1-sparing agents have now started to impact on clinical practice. Two large clinical outcomes studies with these agents have been published. Both indicate at least some benefit, but raise interesting questions with regard to the use of these agents in the clinical setting.
Louw
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Gastrointestinal Clinic, New Groote Schuur Hospital, Observatory 7925, South Africa. jalouw@curie.uct.ac.za
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