Peptic ulcer disease

Patients with peptic ulcer disease are commonly seen by family physicians. The incidence of duodenal ulcer seems to be declining in the United States. Avoidance of inciting factors and the use of antacids and cimetidine are indicated in the treatment of duodenal ulcers. New histamine H2 receptor antagonists and site-specific mucosal barrier agents are now available. Gastric ulcer differs from duodenal ulcer in many ways, and gastric carcinoma must be considered in the differential diagnosis. Other important entities include Zollinger-Ellison syndrome, "stress" ulceration, and peptic ulcer disease in children.