CRITICAL ISSUES IN THE PATHOPHYSIOLOGY AND MANAGEMENT OF PEPTIC-ULCER DISEASE

Abstract

OBJECTIVE: To discuss some of the critical issues in the pathophysiology and management of peptic ulcer disease. OPINION: Peptic ulcer disease has multiple causes, although gastric acid has traditionally been considered the primary aggressive factor. Helicobacter pylori infection is established as a major causative factor, but some aspects of the mechanisms by which H. pylori causes peptic ulceration remain unclear. Treatment with proton pump inhibitors (PPIs) is the most effective means of healing peptic ulcers. In addition to healing a higher proportion of ulcers than H2-receptor antagonists, PPIs provide faster healing and relief of symptoms. The ability of PPIs to produce effective and s..