CLINICAL CHARACTERISTICS AND MEASURES AGAINST IDIOPATHIC REFRACTORY GASTRIC ANTRAL ULCERS

Abstract

Idiopathic gastric ulcer (IGU) without Helicobacter pylori infection or a history of non-steroidal anti-inflammatory drugs used is rare in Japan, and its clinical characteristics have still not been elucidated. A type of IGU, idiopathic refractory gastric antral ulcer (RGAU), has been described as that with clinical course refractory to proton pump inhibitors (PPIs) for 8 weeks or recurrent gastric antral ulcers after stopping PPIs or switching to histamine 2 receptor antagonists. Because of their refractoriness and high recurrence rates, early detection by their endoscopic characteristics is necessary. RGAUs often present as small, round, and deep hole-like ulcers with reddish edematous submucosal tumor-like elevation in the greater curvature of the gastric antrum. In this article, we review the endoscopic characteristics of IGUs, especially of idiopathic RGAUs.