1993 Volume 35 Issue 6 Pages 1282-1289
The proton pump inhibitor (PPI) has a more powerful, and longer lasting action in inhibiting gastric acid secretion than the H2-blocker, and thus it is an antiulcer agent with the earlier cure for ulcer lesions. However, concerns have been expressed that it presents a peculiar healing morphology such as protrusions of the base of ulcers, in many cases which could lead to relapse of the ulcer. In this study differences between PPI and H2-blocker in regard to morphological changes in the ulcer were assessed. Seventy-six patients (46 were administered PPI and 30 were administered H2-block-ers) with active gastric ulcers were observed every two weeks using an electronic endos-cope (TGS-50B ; Toshiba-Machida). The pattern of regenerated mucous membrane was evaluated by imaging analysis to calculate the oval specification (OSF) value. Black ink drops were deposited at 4 locations on the periphery of the ulcer, and the changes in the distance between ink spots were studied. Although no difference was observed in the OSF value during the active stage, during the healing process and scarring stage, the PPI group showed significantly higher values (Figure 4). In our study of ink spots distances, no significant difference was observed between the two groups. Therefore it is thought that the appearance of a long and narrow regenerative mucousal pattern with a high OSF value in the PPI group is not resulted from shrinkage of the ulcer but rather the rapid expansion of regenarated mucous membrane.
