Peptic ulcer disease.

Area of Science:

• Gastroenterology
• Epidemiology
• Pharmacology

Background:

• Peptic ulcer disease historically caused significant morbidity and mortality.
• Recent decades show a marked decrease in peptic ulcer disease incidence.
• Key factors include potent acid suppressants and the discovery of Helicobacter pylori.

Purpose of the Study:

• To review the revolution in understanding and managing peptic ulcer disease over the past 25 years.
• To examine the impact of non-steroidal anti-inflammatory drugs (NSAIDs) and low-dose aspirin on ulcer disease.
• To discuss strategies for drug-induced ulcers and H. pylori-negative, NSAID-negative ulcers.

Main Methods:

• Review of epidemiological trends in peptic ulcer disease.
• Analysis of the impact of Helicobacter pylori discovery on disease understanding and treatment.
• Examination of the role of NSAIDs and aspirin in current ulcer pathogenesis.
• Discussion of therapeutic and preventive strategies for drug-induced ulcers.

Main Results:

• Significant decline in peptic ulcer disease rates attributed to acid suppressants and H. pylori eradication.
• Non-steroidal anti-inflammatory drugs (NSAIDs) and low-dose aspirin are now major causes of peptic ulcers.
• H. pylori-negative, NSAID-negative ulcers represent a rare but growing clinical challenge.

Conclusions:

• Advances in medicine have transformed peptic ulcer disease management.
• NSAID and aspirin use continue to drive ulcer disease, requiring targeted prevention and treatment.
• Further research is needed for managing complex ulcer cases, including H. pylori-negative, NSAID-negative ulcers.