Natural history of severe duodenal ulcer disease.

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dc.contributor.authorKonar, Aen_US
dc.contributor.authorDas, A Sen_US
dc.contributor.authorDe, P Ken_US
dc.contributor.authorRoy, Aen_US
dc.contributor.authorMazumder, D Nen_US
dc.date.accessioned1998-04-01en_US
dc.date.accessioned2009-05-29T02:00:28Z
dc.date.available1998-04-01en_US
dc.date.available2009-05-29T02:00:28Z
dc.date.issued1998-04-01en_US
dc.description.abstractBACKGROUND: A subset of patients with chronic duodenal ulcer has severe ulcer diathesis in the form of frequent relapses and complications like perforation and hemorrhage. We observed the effect of drug treatment on the natural history of this subset. METHODS: Of 526 patients diagnosed to have chronic duodenal ulcer by endoscopy, 23 patients with severe diathesis were available for long follow-up (mean period 36 months). Each patient was assessed clinically and endoscopically every 2 months for at least 12 months and then every 3 months or when symptomatic. Helicobacter pylori status was assessed during endoscopy. The effect of antisecretory drugs and anti-H. pylori therapy on natural history was determined. RESULTS: Thirteen of 23 patients (56%) had refractory ulcers; six responded to double dose of H2-receptor antagonists (H2RA) for 8 weeks and six to omeprazole 40 mg daily for 4-8 weeks. Of 20 patients (87%) who were H. pylori-positive, 15 completed triple-drug therapy; of these, 10 patients eradicated H. pylori. These 10 patients were followed up for 24 months; there were no ulcer relapses within the first 12 months but 8 of them relapsed between 12 and 24 months (total number of relapses 8). Reinfection with H. pylori occurred in 3 patients. In the other 10 patients who remained H. pylori-positive, there were 19 episodes of ulcer relapse in 7 patients over 24 months, in spite of maintenance therapy with H2RA (p < 0.05). CONCLUSIONS: Refractoriness in patients with severe ulcer disease is usually episodic and amenable to larger doses of omeprazole or H2RA. Anti-H. pylori therapy improves the natural history but its effect in preventing ulcer relapse is short lasting (less than 12 months). Recurrence of infection is a problem in our population.en_US
dc.description.affiliationDepartment of Gastroenterology, Institute of Post Graduate Medical Education and Research, Calcutta.en_US
dc.identifier.citationKonar A, Das AS, De PK, Roy A, Mazumder DN. Natural history of severe duodenal ulcer disease. Indian Journal of Gastroenterology. 1998 Apr; 17(2): 48-50en_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/63622
dc.language.isoengen_US
dc.source.urihttps://www.indianjgastro.comen_US
dc.subject.meshAdulten_US
dc.subject.meshAgeden_US
dc.subject.meshAnti-Ulcer Agents --therapeutic useen_US
dc.subject.meshChronic Diseaseen_US
dc.subject.meshDrug Therapy, Combinationen_US
dc.subject.meshDuodenal Ulcer --drug therapyen_US
dc.subject.meshFemaleen_US
dc.subject.meshHelicobacter Infections --diagnosisen_US
dc.subject.meshHelicobacter pylori --isolation & purificationen_US
dc.subject.meshHistamine H2 Antagonists --therapeutic useen_US
dc.subject.meshHumansen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshOmeprazole --therapeutic useen_US
dc.subject.meshRanitidine --therapeutic useen_US
dc.subject.meshRecurrenceen_US
dc.titleNatural history of severe duodenal ulcer disease.en_US
dc.typeJournal Articleen_US
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