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[Refractory peptic ulcer: the pathogenic mechanisms]

B Remacha Tomey1, A Lanas Arbeloa, R Sainz Samitier

  • 1Servicio de Aparato Digestivo, Hospital Clínico Universitario, Zaragoza.

Revista Espanola De Enfermedades Digestivas
|June 1, 1995
PubMed
Summary

Most peptic ulcers heal with standard treatments. However, a small percentage become refractory, with Helicobacter pylori infection and NSAID use being key factors in their development.

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Area of Science:

  • Gastroenterology
  • Internal Medicine
  • Pharmacology

Background:

  • Peptic ulcers typically respond to H2 receptor antagonists or omeprazole.
  • A significant minority (5-10%) of peptic ulcers exhibit resistance to standard treatments.
  • Identifying factors contributing to refractory ulcers is clinically important.

Purpose of the Study:

  • To explore the factors associated with non-healing (refractory) peptic ulcers.
  • To understand the clinical, environmental, and intrinsic elements influencing ulcer healing.
  • To highlight the role of Helicobacter pylori infection and NSAID use in refractory ulcer pathogenesis.

Main Methods:

  • Review of retrospective and prospective studies.
  • Analysis of clinical, environmental, and intrinsic factors.

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  • Focus on recent findings regarding major ulcer causes.

    • Main Results:

    • Standard treatments are effective for most peptic ulcers.
    • 5-10% of peptic ulcers do not heal under standard treatment regimens.
    • Helicobacter pylori infection and NSAID use are increasingly recognized as primary causes of peptic ulcers.

    Conclusions:

    • Refractory peptic ulcers present a clinical challenge.
    • Helicobacter pylori infection and NSAID use are implicated in the development of refractory ulcers.
    • Further investigation into these factors may improve treatment strategies for non-healing ulcers.