[Acute ulcer disease: diagnosis, therapy, complications, indications for surgery]

The development of fiberoptic endoscopy, the creation of drugs with well understood mechanisms of action, and the definition of the role of Helicobacter pylori have resulted in a considerably better understanding of ulcer pathogenesis. This has led to rational concepts of ulcer therapy, which are discussed in detail in this review. Moreover, the role of non-steroidal antiinflammatory drugs in peptic ulcer disease, and the use of drugs and endoscopic measures in treatment of ulcer complications, especially g.i. hemorrhage, are discussed in detail. The implications of these advances with regard to the indications for surgical treatment of peptic ulcer disease are outlined.