[Endoscopic studies on refractory gastric ulcers, especially, linear ulcers, treated with proton pump inhibitor]

Seven patients with refractory gastric ulcers against H2-blocker therapy, were treated with omeprazole, and the endoscopic findings serially followed. Round ulcers improved steadily with treatment in two cases. However, healing of the ulcers was not complete and very small pin-point ulcers remained. Therefore, a prostaglandin E1 analogue was added at the 14 and 16th week of omeprazole therapy. The ulcers healed completely, two weeks later. In five cases with linear ulcers, one case discontinued the taking of omeprazole. The linear ulcers in the other four cases healed completely within 4 to 11 weeks. Endoscopically, some parts of the linear ulcers were initially scarred and the ulcers were divided into several short ulcers. The ulcers separated there after and healed respectively. These findings suggest that the healing process of linear ulcers may represent the reversed course of the developing process of linear ulcers. The results indicate that omeprazole is highly effective for the treatment of refractory gastric ulcers.