title: Refractory peptic ulcer disease.
abstract: Refractory PUD is a diagnostic and therapeutic challenge. Optimal management of severe or refractory PUD requires a multidisciplinary team approach, using primary care providers, gastroenterologists, and general surgeons. Medical management has become the cornerstone of therapy. Identification and eradication of H pylori infection combined with acid reduction regimens can heal ulceration and also prevent recurrence. Severe, intractable or recurrent PUD and associated complications mandates a careful and methodical evaluation and management strategy to determine the potential etiologies and necessary treatment (medical or surgical) required.
authors.affiliation: Department of Surgery, University of Michigan Health System, University of Michigan School of Medicine, Room 1C421, University Hospital, 1500 East Medical Drive, Ann Arbor, MI 48109-0033, USA. lenan@umich.edu
authors.forename: Lena
authors.initials: L
authors.lastname: Napolitano
mesh_terms: D000863:Antacids / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D006471:Gastrointestinal Hemorrhage / Q000188:drug therapy / Q000209:etiology* / Q000601:surgery; D016481:Helicobacter Infections / Q000150:complications* / Q000188:drug therapy / Q000601:surgery; D016480:Helicobacter pylori; D006801:Humans; D010349:Patient Compliance; D010437:Peptic Ulcer / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery; D010439:Peptic Ulcer Perforation / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D012307:Risk Factors; D017211:Treatment Failure
chemical_list: D000863:Antacids; D000900:Anti-Bacterial Agents; D000897:Anti-Ulcer Agents