Abstract
We studied on recurrence of gastric and duodenal ulcers. There have been many previous reports on this subject and we also reported recurrence of gastric ulcers at the 2nd. Asian Pacific Congress in Singapore in 1976. Since then we have approached to clarify differences in recurrence between gastric and duodenal ulcers. During a seven-year period from 1970 to 1977, we followed up a total of 305 cases of gastric ulcers and 259 cases of duodenal ulcers for more than six months after complete healing on endoscopy. As a result, recurrence was found in 36.7% of the gastric ulcers and in 34.71 of duodenal ulcers. The recurrence rate similar between both groups and was higher in males, at an open stage at the initial examination and in cases of delayed healing. In general we treat peptic ulcers with anti-cholinergic, anti-pepsin and mucosal defensive drugs So and studied relation between the recurrence rate and medical treatment. Recurrence rates of gastric and duodenal ulcers were predominantly higher in cases of discontinued medical treatment. In gastric ulcer, 58 (50.4%) of 115 patients who discontinued medication had recurrences. On the other hand, only 20.9 % recurred in patients who continued medical treatment. A similar tendency was noted in duodenal ulcers. 44.3% of the discontinued medication group had recurrences but only 26% in continued medication group. Regarding the relationship between an accumlated recurrence rate and time interual until recurrence, 50.8 % of patients with gastric ulcers had recurrences within one year after healing of the initial ulcers and 75% had recurrences within two year. In duodenal ulcer, there was a similar tendency in recurrence as in gastric ulcer, 44.5% of patients had recurrences within one year after healing of the initial ulcer and 75.5 % had recurrences within two year. We, therefore, need to observe patients very carefully during the first year after healing of the initial ulcers. With regard to gastric acid secretion, there was no difference between non-recurrent and recurrent groups.
