Factors relevant to the prognosis of chronic gastric ulcer.

Piper, D. W.; Greig, Margaret; Coupland, G. A. E.; Hobbin, E; Shinners, Jane

doi:10.1136/gut.16.9.714

Cited by 40 publications

(7 citation statements)

References 18 publications

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“…Our results, based on air-contrast studies, and, in many patients, confirmed by endos copy, are in keeping with the general findings that gastric ulcers tend to occur in the lower stomach in an area adjacent to the boundary between body and antral mucosa on the antral side of the junction zone (16)(17)(18)(19)(20). Stemmermann et al (20) showed that the distance of an ulcer from the pyloric ring and the extent of intestinal metaplasia are closely related.…”

Section: Discussionsupporting

confidence: 70%

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The Location of Chronic Gastric Ulcer

Thomas¹,

Greig²,

MclNTOSH³

et al. 1980

Digestion

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Ulcer size, age, sex, alcohol and analgesic intake and cigarette consumption were studied in relation to the site of the ulcer in 215 patients with chronic gastric ulcer, of whom 96 were initial and 115 recurrent ulcers. Ulcer site was classified into upper (U), middle (M) and lower (L) thirds of the stomach, on X-ray films of air-contrast barium studies. The ulcers were situated in the upper third in 37 patients (17%), middle third in 90 patients (42%) and lower third in 88 patients (41%), i.e., significantly more in M and L compared to U (p < 0.001). 135 ulcers were on the lesser curve (63%) with more in L and M compared to U (p < 0.0005). Posterior wall ulcers accounted for 29.3%. Ulcers were smallest in L (mean 28.8 mm²) compared to those in M (mean 66.1 mm²) and U (mean 64.4 mm²) (p < 0.001). Mean size overall was 49.0 mm. The mean age of the patients was 58.8 years with no significant differences in age between U, M and L (p > 0.9). The M/F ratio in the whole series was 0.6 which varied with ulcer site, being 0.3 in U (differing significantly from the whole series, p < 0.05), 0.4 in M and 1.2 in L (significantly different from the whole series, p < 0.01) and from U (p < 0.01). Initial ulcers did not differ from recurrent ulcers except in women where initial ulcers were more common in M and L, whereas recurrent ulcers were more common in U. The independent variables, namely, alcohol and analgesics (with the exception of smoking), were not determinants of ulcer site, size or position once the patients were segregated by sex. In men only, there were interactions between L and lesser curve site (p < 0.004) and L and smoking (p < 0.03).

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Section: Discussionsupporting

confidence: 70%

“…Only 48% of these patients also had a gastric biopsy per formed. but a previous study has shown that the prevalence of missed cancer in patients so diagnosed is 1% (18).…”

Section: Diagnostic Criteriamentioning

confidence: 99%

The Location of Chronic Gastric Ulcer

Thomas¹,

Greig²,

MclNTOSH³

et al. 1980

Digestion

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“…Both the 4-week healing rates o f 59% for ranitidine and 64% for cimetidine, and the 8-week healing rates o f 91 % for raniti dine and 91 % for cimetidine are similar to those reported in two single-blind compara tive studies [17,18]. The results are also sim ilar to several placebo-controlled double blind studies o f ranitidine in gastric ulcer ation [9, 10], except for a higher healing rate at 4 weeks (76%) in one study [9]; and a large open study has also recorded a cumulative 8-week healing rate with ranitidine o f 87% [11], It is confirmed that large ulcers take lon ger to heal than smaller ulcers [19][20][21], but there was no difference in the healing rates between prepyloric ulcers and ulcers in the body of the stomach, as has been reported previously [11,22].…”

Section: Discussionmentioning

confidence: 50%

Comparison of Ranitidine and Cimetidine in the Treatment of Chronic Gastric Ulcer

Kellow¹,

Barr²,

Cowen³

et al. 1983

Digestion

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The aim of the study was to compare the effectiveness of ranitidine and cimetidine in accelerating the healing of chronic gastric ulcer. 44 outpatients with endoscopically proven gastric ulcer whose duration of symptoms was greater than 4 weeks and who were without major systemic disease were studied. Patients were randomly allocated to receive either ranitidine, 150 mg twice a day or cimetidine, 200 mg three times a day and 400 mg at night for 4 weeks. If the ulcer had not healed, treatment was continued for a further 4 weeks, when patient assessment and endoscopy were repeated. By 4 weeks, 13 of 22 patients taking ranitidine (59%) and 14 of 22 patients taking cimetidine (64%) had healed (p₂ = 1.0, 95% confidence interval -20%, 38%). At 8 weeks, 91 % on ranitidine and 91 % on cimetidine had healed (p₂ = 1.0, 95% confidence interval -18 %, 18%). Symptomatic improvement was similar with both drugs. Smoking did not influence healing rates. There were no major side effects with either medication. It is concluded that ranitidine and cimetidine are of similar efficacy in accelerating the healing of chronic gastric ulcer.

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“…Recurrence rate also does not appear to be substantially influenced by aspirin [76]. In the study by Caruso and Bianchi Porro [34] the annual recurrence rate in patients on NSAIDs, including aspirin, was 11 (46%) of 24 peptic ulcers.…”

Section: Aspirin and Peptic Ulcer Healing And Recurrencementioning

confidence: 97%