[Natural history of duodenal ulcer]

The authors have studied the natural history of duodenal ulcer from published data, in an attempt to determine precisely the evolutive potential of this disease both spontaneously and during its treatment. They deal successively with the risk of complication and the short- or long-term influence of medical and surgical treatment on the occurrence of exacerbations and complications. The role played by Helicobacter pylori in healing of the ulcer and in the long-term course of the ulcerous disease, as well as the problems concerning its duration and mortality, are discussed. The data clearly show that the medical and surgical treatment of duodenal ulcer can slow down, at least temporarily, the course of the disease. Other studies are needed before drawing firm conclusions concerning the relationship between H. pylori and duodenal ulcer, even though numerous studies seem to have demonstrated that eradication of this micro-organism is associated with a substantial decrease in the risk of recurrent ulcer.