[Non-Helicobacter pylori, Non-nonsteroidal Anti-inflammatory Drug Peptic Ulcer Disease].
Non-Helicobacter pylori, non-NSAID peptic ulcer disease (PUD), termed idiopathic PUD, is increasing in Korea. Diagnosis is based on exclusion of common causes such as H. pylori infection, infection with other pathogens, surreptitious ulcerogenic drugs, malignancy, and uncommon systemic diseases with upper gastrointestinal manifestations. The clinical course of idiopathic PUD is delayed ulcer healing, higher recurrence, higher re-bleeding after initial ulcer healing, and higher mortality than the other types of PUD. Genetic predisposition, older age, chronic mesenteric ischemia, cigarette smoking, concomitant systemic diseases, and psychological stress are considered risk factors for idiopathic PUD. Diagnosis of idiopathic PUD should systematically explore all possible causes. Management of this disease is to treat underlying disease followed by regular endoscopic surveillance to confirm ulcer healing. Continuous proton pump inhibitor therapy is an option for patients who respond poorly to the standard ulcer regimen.
Department of Internal Medicine, Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul, Korea.
Young Woon
YW
Chang
D000375:Aging; D004266:DNA Virus Infections / Q000150:complications; D004164:Diphosphonates / Q000009:adverse effects; D016481:Helicobacter Infections / Q000175:diagnosis; D006801:Humans; D010437:Peptic Ulcer / Q000175:diagnosis* / Q000208:ethnology / Q000209:etiology; D013315:Stress, Psychological; D019966:Substance-Related Disorders / Q000150:complications; D014376:Tuberculosis / Q000150:complications
D004164:Diphosphonates
Idiopathic peptic ulcer; Non-Helicobacter pylori; Non-nonsteroidal anti-inflammatory agents; Proton pump inhibitors