[Japanese guideline for the management of gastric ulcer]

Japanese guideline for the management of gastric ulcer prepared by a research group supported by government funding was published in 2003 as a concise book for use in general practice. Overall management strategy classified based on etiology of ulcer was shown as a flow chart. Recommendation of treatment strategy for NSAID ulcer with PPI, and for H. pylori-positive gastric ulcer with eradication therapy are in line with internationally acknowledged consensus. A number of so-called mucoprotective drugs most of which are available in Japanese market alone, however, were given low priority when choosing single regimen, and their use in combination with acid suppressant, the most popular ulcer regimens in Japan, was not recommended due to lack of reliable evidence. Though it will take some time for general physicians to widely adopt this guideline, it undoubtedly will serve for reasonable gastric ulcer management in Japan.