Pathogenesis and therapy of gastric and duodenal ulcer disease

Med Clin North Am. 2002 Nov;86(6):1447-66, viii. doi: 10.1016/s0025-7125(02)00083-4.


Despite the decreasing frequency of Helicobacter pylori-induced peptic ulcers, peptic ulcer disease remains a major clinical problem partly because nonsteroidal anti-inflammatory drug ulcers have increased in frequency. The reduction in nonsteroidal anti-inflammatory drug ulcers by use of selective cyclooxygenase-2 inhibitors will not eliminate the problem because of increased use of aspirin for cardiovascular prophylaxis. This article reviews current concepts of peptic ulcer pathogenesis and therapy according to ulcer etiology; discusses potential interactions between etiologies; and considers the therapy for H pylori infection including the effects of antimicrobial resistance, and the role of bismuth quadruple therapy or furazolidone salvage therapy.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects
  • Duodenal Ulcer / chemically induced
  • Duodenal Ulcer / etiology*
  • Duodenal Ulcer / microbiology
  • Duodenal Ulcer / therapy*
  • Helicobacter Infections / diagnosis
  • Helicobacter Infections / drug therapy
  • Helicobacter pylori
  • Humans
  • Stomach Ulcer / chemically induced
  • Stomach Ulcer / etiology*
  • Stomach Ulcer / microbiology
  • Stomach Ulcer / therapy*


  • Anti-Inflammatory Agents, Non-Steroidal