DIAGNOSIS AND TREATMENT OF IDIOPATHIC GASTRIC ULCERS

Abstract

Idiopathic gastric ulcers are defined as ulcers with an unknown etiology and those caused by agents other than Helicobacter pylori and non-steroidal anti-inflammatory drugs, after rare conditions have been excluded. Idiopathic peptic ulcer disease (IPUD) includes idiopathic gastric and/or duodenal ulcers. Recent studies have reported an increase in the percentage of patients with IPUD among those with peptic ulcers, which is possibly attributable to a decline in H. pylori infection rates. IPUD predominantly affects elderly individuals and clinically presents with a high incidence of comorbidities, antral predominance, and high recurrence rates. Proton pump inhibitors or potassium-competitive acid blockers are recommended for initial treatment of IPUD; however, healing rates in patients with IPUD are significantly lower than those observed in patients with H. pylori ulcers. The pathogenesis of IPUD remains unknown, although stress and age-induced abnormalities of the gastric mucosal defense are considered possible contributors.