The therapeutie efficacy of ranitidine was evaluated itn 48 in- and out- patients with endoscopically diagnosed 18 cases of gaetric ulcer and 30 casea of ducnienal ulcer. In the open study, every pabenta was treated with ranitidine 150 mg b.i.d. for 4 weeks, and waa followed up by gastroscopy after 4 weeks of the treatment. The reeults obtained were summarized as follows; 1) 15 out of 18 cases (83. 3%) of gastric ulcers and 26 out of 30 cases (86. 7%) of duodenal ulcers had been completely healed up in 4 weeks. 2) There was a significant relationship between healing of ulcer and the relief of symptoms (x =6.12, P<0.005).3) There were no significant untoward reactions, efther subjective or objective, to the administration of the drug, except one case of severe epigastic discomfort. In conclusion ranitidine appears to be fairy effective and safe for the treatment of patient with peptic ulcr diseases.
Duodenal Ulcer ; Gastroscopy ; Humans ; Peptic Ulcer* ; Ranitidine* ; Stomach Ulcer ; Ulcer

Helicobacter pylori infection causes chronic gastritis and its well documented con- sequences are peptic ulcer disease and gastric neoplasia. As duodenal ulcer is often associated with gastroesophageal reflux disease and antral gastritis is a frequent finding in patients with reflux disease, H. pylori infection may be a common cause of both conditions. Recent studies reveal that H. pylori has no role in the pathogenesis of reflux esophagitis. Furthermore, there are some arguments on whether H. pylori infection may have a protective role in reflux esophagitis. We have experienced two cases of reflux esophagitis after cure of H. pylori infection. H. pylori eradication therapy was performed in two patients who have gastric and/or duodenal ulcer with omeprazole and two anti-biotics (clarithromycin and amoxicillin). After cure of H. pylori infection, reflux esophagitis was demonstrated in these patients by endoscopy.
Duodenal Ulcer ; Endoscopy ; Esophagitis, Peptic* ; Gastritis ; Gastroesophageal Reflux ; Helicobacter pylori* ; Helicobacter* ; Humans ; Omeprazole ; Peptic Ulcer ; Stomach Ulcer

BACKGROUND: It is well known fact to the patients of duodenal ulcer that their condition is frequently accompanied with reflux esophagitis. Therefore this condition is called an "acid-related disorder" because it is commonly associated with increased acidity. But there has been disputes on the effect of Helicobacter pylori eradication in these two conditions and whether H. pylori infection may have a protective role in reflux esophagitis. Only few reports have dealt with the prevalence of reflux esophagitis and gastroesophageal reflux in patients with peptic ulcer. The aim of this study is to estimate the prevalence of gastroesophageal reflux and to analyze the pattern ofthe pathologic reflux in peptic ulcer patients. MATERIALS AND METHODS: The study population consisted of 57 patients with endoscopically confirmed duodenal and/or gastric ulcer who all underwent 24hr ambulatory esophageal pH monitoring. RESULTS: The prevalnace of gastroesophageal reflux in peptic ulcer patients was 54.2% and 54.5% in gastric ulcer, and 62.5% in duodenal ulcer, 50% in combined ulcer, respectively. The prevalence of gastroesophageal reflux in the control group was 22.7%. CONCLUSION: We discovered significantly higher prevalence of gastroesophageal reflux in patients with peptic ulcer disease than in those without it. In conclusion, the presence or absence of gastroesophageal reflux must be considered in the setting of peptic ulcer disease management.
Disease Management ; Dissent and Disputes ; Duodenal Ulcer ; Esophageal pH Monitoring ; Esophagitis, Peptic ; Gastroesophageal Reflux* ; Helicobacter pylori ; Humans ; Peptic Ulcer* ; Prevalence ; Stomach Ulcer ; Ulcer

Peptic ulcer can occur anywhere in the gastrointestinal tract that contact with acid and pepsin. But usually peptic ulcer occurs at the stomach and duodenum and the location of peptic ulcer are localized to specific area within the stomach and duodenum. So I think that predilection of peptic ulcer to localized area may have clue for releaving the pathogenesis of peptic ulcer. So I studied the location of peptic ulcer for the basic reserch of ulcer pathogenesis by means of dividing stomach into antrum, angle, lower body, middle body, upper body and lesser curvature, anterior wall, greater curvature, posterior wall and duodenum into anterior wall, lesser curvature, posterior wall, and greater curvature. The results obtained were as follows: 1) The chronic gastric ulcer was most common in the angle of lesser curvature (22.9%) and second common in the antrum of lesser curvature (22.3%). 2) The location of chronic and acute gastric ulcer was similar. 3) The proximal migration of ulcer site according to increasing age was not observed. 4) Chronic duodenal ulcer was occurred commonly in the lesser curvature (41.8%) and anterior wall (38.3%). 5) As the age increase, the incidence of chronic duodenal ulcer in the lesser curvature was increased and that of chronic duodemal ulcer in the anterior wall was decreased. 6) Acute ulcer of stomach and duodenum has no predilection site.
Duodenal Ulcer ; Duodenum ; Gastrointestinal Tract ; Incidence ; Pepsin A ; Peptic Ulcer* ; Stomach ; Stomach Ulcer ; Ulcer

BACKGROUND: Helicobacter pylori infection is thought to be an important factor in the pathogenesis af gastric and duodenal ulcer. But in Korea, there are few studies on the prevalence of Helicobacter pylori infection in peptic ulcer patients and their relationship between the location of ulcers and Helicobacter pylori infection. The aim of this study was to investigate the prevalence af Helicobacter pylori infection of gastric and duodenal ulcer patients in Korea and the relationship between the location of ulcers and Helicobacter pylori infection. METHODS: We studied 476 consecutive patients with duodenal ulcers or benign gastric ulcer which were diagnased by gastrofiberscopy in Family Medicine of Hanil Hospital from January 1995 to December 1998. Helicobacter pylori infection was evaluated with rapid urease test ( CLO test) in 72.7% patients. RESULTS: The test rate of CLO test was not significantly different by sex, age and site of gastric ulcer lesions, but test rate in the gastric ulcer was significantly lower than in the duodenal ulcer. The prevalence of Helicobacter pylori infection diagnosed with CLO test was 90.1%. The prevalence cf Helicobacter pylori infection was not significantly different between rnales and females. Also it was also not significantly different according to age. 90.8% of those with gastric ulcer patients and 88.9% of the duodenal ulcer had Helicobacter pylori infection, but the difference was not significant. 94.6% of gastric ulcers located in only one area had Helicobacter pylori infection, compared to 83.6% of gastric ulcers which was located in multiple areas. The prevalence of Helicobacter pylori infection was significantly lower in patients who had lesions located in multiple areas. CONCLUSIONS: We condude that the majurity of peptic ulcer patients in Korea have Helicobacter pylori infection. Gastric uker located in multiple areas had significantly lower prevalence af Helicobacter pylori infection, which may suggest that gastric ulcers in multiple areas have other etiologic factors.
Duodenal Ulcer ; Female ; Helicobacter pylori* ; Helicobacter* ; Humans ; Korea ; Peptic Ulcer* ; Prevalence* ; Stomach Ulcer ; Ulcer ; Urease

BACKGROUND: Bleeding peptic ulcer is the most common cause of upper gastrointestinal bleeding. Various different endoscopic hemostatic methods were introduced to treat bleeding peptic ulcer. Many studies reported the efficacy and comparision of various methods. Endoscopic injection therapy is the most comman method among them because it is inexpensive and easy in use. Complications of injection therapy such as aggravation of bleeding, tissue neerosis and perforation were repoted rarely. Recently endoscopic hemoclipping method is considered to be safe and effective hemostatic method for upper gastrointestinal bleeding. METHODS: During the period between January 1993 and August 1996, we have conducted clinical trial and retrospective analysis among 100 patients in whom active bleeding or visible vessel was identified. RESULTS: 1) Three groups was divided, Hemoclip group 26 cases, Hypertonic Saline Epinephrine(HSE) group 59 cases, Combination group 15 cases. 2) The sources of bleeding in Hemoclip group were gastric ulcer in 23 Cases and duodenal ulcer in 3 cases, and in HSE group, gastric ulcer in 44 case, duodenal ulcer 14 cases and stomal ulcer in one case, and in combination group, gastric ulcer in 10 cases, duodenal ulcer in 3 cases and stomal ulcer in two cases. HSE and combination method were performed more than Hemoclip method in duodenal ulcer(23.7% and 20.0% versus 11.5%). 3) As the stigmata of bleeding in Hemoclip and HSE and Combination group, spurting were seen in 5 cases and 3 cases and 4 cases, and oozing in 10 cases and 17 cases and 3 cases, and nonbleeding visible vessel in 11 cases and 39 cases and 8 cases, respectively. Hemoclip method was performed more than HSE method in active bleeding state(57.6% versus 33.9%). 4) Initial hemostasis was achieved in 24 cases(92.3%) in Hemoclip group and 52 cases(88.1%) in HSE group, 13 cases(86.7%) in Combination group. 5) The rebleeding developed in 1 case(4.2%) in Hemoclip group and 8 cases(15.4%) in HSE group and 1 case(7.6%) in Combination group, the emergent operation was undewent 2 cases(7.7%) in Hemoclip group and 10 cases(17.0%) in HSE group and 1 case(6.7%) in Combination group, respectively. 6) The death was noticed in 1 cases(3.9%) in Hemoclip group and 2 cases(3.4%) in HSE group and 2 case(13.3%) in Combination group, repectively. 7) Permanent hemostasis by only endoscopic treatment was achieved in 24 cases(92.3%) in Hemoclip group and 48 cases(81.4%) in HSE group, 12 cases(80.0%) in Combination group. 8) Complication was noticed only in HSE group, aggravation of bleeding in one case and hematoma in two cases. CONCLUSION: Hemoclip method was effective hemostatic method same as HSE injection method, and safe method weth low complication in bleeding peptic ulcer. We suggest more detail selection of endoscopic hemostatic method in variously individualized endoscopic features.
Christianity ; Duodenal Ulcer ; Epinephrine* ; Hematoma ; Hemorrhage* ; Hemostasis ; Humans ; Peptic Ulcer* ; Retrospective Studies ; Stomach Ulcer ; Ulcer

The serum pepsinogen (PG) assay findings are correlated with the status of Helicobacter pylori infection, but there are controversies on the link with upper gastrointestinal (UGI) endoscopic findings. The aim of this study was to determine the significance of a serum PG assay for correlating with endoscopic findings in H. pylori-seroprevalent adult population. Korean adults who visited for a health check-up were included consecutively. Subjects after gastrectomy or H. pylori eradication were excluded. After completing the serum PG assay and anti-H. pylori immunoglobulin G (IgG) titer on the same day of UGI endoscopy, subjects with equivocal serology test finding or gastric neoplasm were excluded. Of the 4,830 included subjects, 3,116 (64.5%) were seropositive for H. pylori. Seropositive finding was related to high serum PG I (P < 0.001) and PG II (P < 0.001) concentrations, low PG I/II ratio (P < 0.001), old age (P < 0.001), and male gender (P = 0.006). After adjusting age and gender, the serum PG I and II concentrations were positively correlated with the presence of nodular gastritis (NG) (all P = 0.003). The serum PG I was positively correlated with gastric ulcer (P = 0.003), and it was correlated with duodenal ulcer in seropositive subjects (P = 0.008). The PG I/II ratio was positively correlated with erosive esophagitis, while it was inversely related to chronic atrophic gastritis and metaplastic gastritis (all P < 0.001). Our findings suggest that the serum PG assay finding correlates well with the UGI endoscopic finding. A higher serum PG concentration in subjects with NG and peptic ulcer disease suggests that endoscopic findings reflect gastric secreting ability.
Adult ; Duodenal Ulcer ; Endoscopy ; Esophagitis ; Gastrectomy ; Gastritis ; Gastritis, Atrophic ; Helicobacter pylori ; Humans ; Immunoglobulin G ; Male ; Pepsinogen A* ; Peptic Ulcer ; Stomach Neoplasms ; Stomach Ulcer

Treatment of peptic ulceration by suppression of gastric aeid, secretion with the histamine H,-receptor antagonist, cimetidine is now well established. Prior to the availability of ranitidine, cimetidine was the only histamine H2-receptor antagonist available for treatment of duodenal and gastric ulceration. The aim of this study was to compare the efficacy of ranitidine and cimetidine in accelerating the healing of duodenal ulcer. The therapeutic trials comparing ranitidine with cimetidine in a total of 44. out-patients with endoscopically diagnosed duodenal ulcer ivere entered into the study. 28 patients were treated with ranitidine 150mg twiee daily, and 16 patients with cimetidine 200 mg 4 times daily for 4 weeks. Overall endoscopic healing rates were 75%, on ranitidine and 64.3% on cimetidine, and so ranitidine appears to be slightly more effective than cimetidine although too small numbers af patients were studied to detcet any difference between drugs. Aa ranitidine is effective with administration twice daily, patient compliance may be better than with the 4 times daily treatment regimen adopted with cimetidine, though has not yet to be adequately demonstrated. There were no significant side-effects, either ranitidine or cimetidine, to the administration of the drug, except a case of dyspepsia on cimetidine regimen.
Cimetidine ; Duodenal Ulcer ; Dyspepsia ; Histamine ; Humans ; Outpatients ; Patient Compliance ; Peptic Ulcer* ; Ranitidine ; Stomach Ulcer

The double pylorus is a rare condition consisting of a double communication between gastric antrum and duodenal bulb. Some investigators postulate that the doubling of the pyloric channel is a congenital phenornenon, but others believe that it is an acquired lesion. A 72 year-old-man was admitted to this hospital because of epigastric pain for 1 month. Upper G-I series revealed thickened rnucosal folds of pylorus and duodenal bulb and dilated, deformed duodenal bulb filled with barium materials. Endoscopic findings also showed two ovoid large openings of the pyloric channel divided by smooth thickened septum and multiple gastroduodenal ulcers. We thought that this case was an acquired lesion. The relevant literatures on the subject were reviewed.
Barium ; Duodenal Ulcer ; Humans ; Peptic Ulcer ; Pyloric Antrum ; Pylorus* ; Research Personnel ; Stomach Ulcer

BACKGROUND/AIMS: Acute peptic ulcer bleeding is the most common cause of upper gastrointestinal bleeding, and needs urgent management in cases including large amounts of blood loss. Ernergency endoscopy was performed and evaluation was made on the risk factors of rebleeding in peptic ulcer patients and the efficacy of ethanol injection therapy. METHODS: The clinical and endoscopic variables were evaluated according to the rebleeding rates and the efficacy of ethanol injection therapy for hemostasis and prevention of rebleeding in 161 cases including gastric ulcers (GU) with bleeding (M: F 134: 27, mean age 56.5 years) and 136 cases including duodenal ulcers (DU) with bleeding (M: F 111: 25, mean age 40.7 years).
Duodenal Ulcer ; Endoscopy ; Ethanol* ; Hemorrhage ; Hemostasis ; Humans ; Peptic Ulcer* ; Risk Factors* ; Stomach Ulcer