학술논문
Background factors of idiopathic peptic ulcers and optimal treatment methods: a multicenter retrospective Japanese study
Document Type
Journal Article
Author
Akihito Nagahara; Akitoshi Hakoda; Atsushi Irisawa; Hiroki Nishikawa; Hiroki Tanabe; Hiroko Hosaka; Hiromi Kataoka; Hirotada Nishie; Junichi Iwamoto; Katsunori Iijima; Kazuhide Higuchi; Kazuhiro Mizukami; Kazuhiro Ota; Kazunari Murakami; Kazuyuki Narimatsu; Kazuyuki Tanaka; Koh Fukushi; Koji Otani; Kunio Kasugai; Masahide Ebi; Masakatsu Nakamura; Nobuaki Yagi; Noriaki Sugawara; Noriyuki Nakajima; Osamu Handa; Rieko Mukai; Ryota Hokari; Shigeto Koizumi; Shinichiro Shinzaki; Shinpei Kawaguchi; Takahisa Furuta; Taro Iwatubo; Tomohisa Takagi; Toshihiko Tomita; Toshihisa Takeuchi; Toshikatsu Okumura; Toshio Uraoka; Tsutomu Takeda; Yasuhiko Maruyama; Yasuhiro Fujiwara; Yuya Nyumura
Source
Journal of Clinical Biochemistry and Nutrition. 2024, 74(1):82
Subject
Language
English
ISSN
0912-0009
1880-5086
1880-5086
Abstract
This study investigated the trends in idiopathic peptic ulcers, examined the characteristics of refractory idiopathic peptic ulcer, and identified the optimal treatment. The characteristics of 309 patients with idiopathic peptic ulcer were examined. We allocated idiopathic peptic ulcers that did not heal after 8 weeks’ treatment (6 weeks for duodenal ulcers) to the refractory group and those that healed within this period to the healed group. The typical risk factors for idiopathic peptic ulcer (atherosclerosis-related underlying disease or liver cirrhosis complications) were absent in 46.6% of patients. Absence of gastric mucosal atrophy (refractory group: 51.4%, healed group: 28.4%; p = 0.016), and gastric fundic gland polyps (refractory group: 17.6%, healed group: 5.9%; p = 0.045) were significantly more common in the refractory group compared to the healed group. A history of H. pylori eradication (refractory group: 85.3%, healed group: 66.0%; p = 0.016), previous H. pylori infection (i.e., gastric mucosal atrophy or history of H. pylori eradication) (refractory group: 48.5%, healed group: 80.0%; p = 0.001), and potassium-competitive acid blocker treatment (refractory group: 28.6%, healed group, 64.1%; p = 0.001) were significantly more frequent in the healed group compared to the refractory group. Thus, acid hypersecretion may be a major factor underlying the refractoriness of idiopathic peptic ulcer.