Peptic-ulcer disease

Lancet. 2002 Sep 21;360(9337):933-41. doi: 10.1016/s0140-6736(02)11030-0.


The discovery of Helicobacter pylori has greatly changed our approach to peptic ulcer disease. Bacterial, host, and environmental factors all have a role in peptic-ulcer disease. Although the prevalence of uncomplicated peptic ulcers is falling, hospital admissions for ulcer complications associated with non-steroidal anti-inflammatory drugs (NSAIDs) are rising. Evidence suggests that prescription of NSAIDs along with potent antiulcer agents and the use of highly selective cyclo-oxygenase-2 inhibitors reduce gastroduodenal ulceration. Whether these therapeutic advances will translate into clinical benefits remains to be seen. The interaction between H pylori and NSAIDs is one of the most controversial issues in peptic ulcer disease. With the fall in rates of H pylori infection, the proportion of ulcers not related to this organism and NSAIDs has risen, which will affect the management of peptic ulcer.

Publication types

  • Review

MeSH terms

  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects
  • Anti-Ulcer Agents / therapeutic use*
  • Clinical Trials as Topic
  • Helicobacter Infections / drug therapy
  • Helicobacter Infections / physiopathology*
  • Helicobacter pylori*
  • Humans
  • Peptic Ulcer* / drug therapy
  • Peptic Ulcer* / microbiology
  • Peptic Ulcer* / physiopathology


  • Anti-Inflammatory Agents, Non-Steroidal
  • Anti-Ulcer Agents