An 83-year-old male with a history of diabetes but with an otherwise intact immune system presented with melena. Upper endoscopy showed gastric and duodenal ulcers. Colonoscopy showed colonic ulcers. Biopsies revealed cytomegalovirus (CMV). Therapy with an antiviral such as ganciclovir should be considered even in an immunocompetent patient if male and over the age of 55, or if they have chroni...

cerebral trauma. While in the hospital, he passed tarry stool and developed anemia. He then suddenly had severe hemorrhage andwent into shock. Emergent upper gastrointestinal tract endoscopy revealed several shallow, geographical ulcers with coagula in the second and third parts of the duodenum (●" Fig. 1). One of the ulcers had an exposed vessel that was bleeding heavily (●" Fig. 2). We stoppe...

23 8 0 31 Summary of the Madras statistics. (1) The number of gastric operations has increased from 8 in 1918 to 260 in 1926. (2) The total of all admissions for these ulcers has increased from 205 in 1922 to 422 in 1926. (3) There was a sudden increase in gastric operations from 12 in 1921 to 132 in 1922. (4) All duodenal ulcers are admitted to the surgical wards and two out of three undergo o...

This study examined time trends in the incidence of peptic ulcers and oesophagitis, and the prescription of acid-inhibiting drugs in the period 1994-2003. Data were retrieved from records in general practices in Flanders, Belgium. The incidence of duodenal ulcers decreased by two-thirds and the incidence of gastric ulcers halved, the incidence of oesophagitis initially increased and decreased s...

In a randomised controlled trial cimetidine 1 g daily for six weeks was compared with placebo in the treatment of recurrent ulcers after gastrectomy or vagotomy for duodenal ulcer. Healing, assessed endoscopically, was seen in seven out of 12 patients given cimetidine and in five out of 12 controls. Four of the controls whose ulcers did not heal were subsequently treated with cimetidine, and in...

Melatonin (MT) and its precursor L-tryptophan (TRP) are implicated in the protection of gastric mucosa against aspirin-induced lesions and in the acceleration of healing of idiopathic gastro-duodenal ulcers, but no information is available whether these agents are also effective in healing of gastroduodenal ulcers accompanied by Helicobacter pylori (H. pylori) infection. In this study three gro...

A conceivable concept for the development of duodenal ulcers in Helicobacter pylori (H. pylori) infected subjects is presented in this chapter. The concept includes an explanation of the fact that only a minority of all H. pylori-infected subjects will develop a duodenal ulcer. Helicobacter pylori infection of the antrum induces a hypersecretion of gastric acid secretion, giving rise to gastric...

Dragstedt believed that basal hypersecretion of gastric acid was the root cause of duodenal ulcer, that the hypersecretion was due to an increased vagal stimulation, and that vagotomy would therefore cure duodenal ulcer. He introduced vagotomy and demonstrated that the operation was successful in curing most patients of their duodenal ulcers. This article reviews how further research in the suc...

OBJECTIVE To demonstrate the role of diet in reducing or aggravating risk of duodenal ulcer (DU). QUALITY OF EVIDENCE MEDLINE was searched from January 1966 to December 2001 for articles on the relationship between diet and lifestyle and DU using the key words duodenal ulcer and diet, fi bre, or lifestyle. Evidence that these factors are associated with DU arose mainly from three case-control a...

THE AUTHORS HIGHLIGHT NEW DEVELOPMENTS IN RESEARCH on Helicobacter pylori. There is now consensus that all patients with newly diagnosed or recurrent duodenal or gastric ulcers who have a positive test result for H. pylori should be treated for the infection. Patients presenting with complications of ulcers, such as bleeding, should also be treated. H. pylori has recently been classified as a d...