Abstract
Relation between the location of gastric ulcer and the fundal gastritis was examined by the endoscopic Congo red test. On the basis of the extent of f undal gastritis, gastric ulcers were classified into two groups, i.e., 1) those associated with slight or no fundal gastritis, and 2) those associated with moderate or severe fundal gast-ritis. In each group, distance between the gastric ulcer and acid-secreting boundary, histological mucosal type around ulcer and healing of ulcer were studied, and obtained the following results. 1. Gastric ulcer associated with slight or no fundal gastritis occured frequently in the angle and the antrum, or in the pyloric gland area adjacent to the fundic gland area. About the half of those associated with slight or no gastritis failed to heal within 3 months after the beginning of the medical treatment. On the contrary, gastric ulcer associated with moderate or severe fundal gastritis was located mostly in the gastric body, or in an area altered by severe fundal gastritis far from the acid-secreting mucosa. Complete healing was observed in 55.4% of the cases with moderate or severe fundal gastritis. 2. Occurrence of the gastric ulcer associated with slight or no fundal gastritis could be explained by Oi's dual cotrol theory on the pathogenesis of ulcer, but that of cases with moderate or severe gastritis could not. 3. This classification of gastric ulcer based on the extent of fundal gastritis is useful not only for the clarification of the pathophysiology of gastric ulcer, but also for the establishment of the guideline of medical treatment of gastric ulcer.
