Current therapy for recurrent ulcer

The natural history of peptic ulcer disease shows a high rate of recurrence over the short term, with the recurrence rate decreasing over a period of many years. Drug therapy does not appear to alter the natural history of the disease. Smoking increases the risk of ulcer recurrence by increasing the rate of gastric emptying, diminishing the secretion of pancreatic bicarbonate, decreasing duodenal luminal pH, reducing mucosal blood flow, and inhibiting mucosal prostaglandin synthesis. There is a probable role for routine maintenance therapy in patients with known recurrent ulcer disease.