Coarse mucosal folds in the duodenum: a twenty-year follow-up

In a 20-year follow-up of 40 patients with coarse duodenal folds, details were obtained about 34 patients of whom 11 had died. Clinical details were reviewed from the remaining 23 patients, and recent barium meal examinations were reviewed from eight patients. Ten of the 23 surviving patients continued to have recurrent dyspepsia, and the radiological appearance in three of the eight recent barium meals showed that coarse mucosal folds persisted. The clinical course of those with coarse duodenal folds is similar to that of peptic ulcer, with recurrent symptoms in some patients continuing for many years, and in others complicated by development of peptic ulcer. Coarse mucosal folds in the duodenum are usually associated with a high acid secretion and treatment to reduce acid secretion is appropriate in view of the severity of symptoms and risk of ulceration.