Helicobacter pylori-negative nonsteroidal anti-inflammatory drug-negative ulcer

Gastroenterol Clin North Am. 2009 Jun;38(2):353-61. doi: 10.1016/j.gtc.2009.03.004.


The most important clinical point for dyspeptic H pylori-negative NSAID-absent negative ulcers is to adequately ensure that these common risk factors are indeed absent. Once that is done, further investigations to include the rare causes of ulcer disease need to be performed and exclusion of underlying malignancy ensured. The possibility of the Zollinger Ellison syndrome should be considered, remembering that proton pump inhibitor therapy will mitigate its classical, clinical features.

Publication types

  • Review

MeSH terms

  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects
  • Diagnosis, Differential
  • Duodenal Ulcer / chemically induced
  • Duodenal Ulcer / etiology
  • Duodenal Ulcer / microbiology
  • Gastrointestinal Neoplasms / diagnosis
  • Helicobacter Infections / complications
  • Helicobacter Infections / diagnosis
  • Helicobacter pylori
  • Humans
  • Peptic Ulcer / chemically induced
  • Peptic Ulcer / etiology*
  • Peptic Ulcer / microbiology
  • Prevalence
  • Risk Factors
  • Stomach Ulcer / chemically induced
  • Stomach Ulcer / etiology
  • Stomach Ulcer / microbiology
  • Zollinger-Ellison Syndrome / diagnosis


  • Anti-Inflammatory Agents, Non-Steroidal