Significance of an exaggerated meal-stimulated gastrin response in the pathogenesis of Helicobacter pylori-negative duodenal ulcer

A multicenter prospective study on the prevalence of Helicobacter pylori‐negative and nonsteroidal anti‐inflammatory drugs‐negative idiopathic peptic ulcers in Japan

“…We conducted a multicenter prospective study and found that IPUs accounted for 12% of peptic ulcers in Japan in 2012–2013, which is consistent with our recent retrospective analysis showing that the proportion of IPUs was 13% using clinical data in 2010 . Several previous studies reported very low rates for the proportion of IPUs (0.9–2.6%) based on a Japanese database from the 1990s . Hence, the present study revealed that the current proportion of IPU is 4‐folds to 10‐folds higher than that in the 1990s, indicating that the proportion of IPUs has been increasing in Japan.…”

“…Five studies on the proportion of IPUs in Japan, based on patient data from the 1990s, reported very low rates of 0.9–2.6% . In addition, a 2000–2002 investigation of patients with hemorrhagic ulcer found that 11% were H. pylori ‐negative and NSAIDs‐negative .…”

“…Five studies on the proportion of IPUs in Japan, based on patient data from the 1990s, reported very low rates of 0.9-2.6%. [19][20][21][22][23] In addition, a 2000-2002 investigation of patients with hemorrhagic ulcer found that 11% were H. pylori-negative and NSAIDsnegative. 24 However, after eliminating patients with a possible history of H. pylori infection based on histological atrophy of the gastric mucosa, the final proportion of patients with IPUs was 1.7%.…”

Helicobacter pylori-Negative Nonsteroidal Anti-Inflammatory Drug-Negative Ulcer

“…We performed gastric function tests in a small group of subjects with idiopathic gastroduodenal ulceration and observed increased acid output, increased gastrin, and accelerated gastric emptying. 38 Exaggerated gastrin response was also observed by Kamada and colleagues 38 in three of nine idiopathic ulcer patients. These abnormalities resemble those occurring in patients with H pylori infection in whom the exaggerated gastrin caused by the infection leads to increased acid output and thus duodenal ulceration.…”

Intravenous proton pump inhibitors for peptic ulcer bleeding: Clinical benefits and limits Hsiu-Chi Cheng, Bor-Shyang Sheu

“…Kamada et al found that only one-third of patients with H. pylori-negative idiopathic duodenal ulcers may have acid hypersecretion [85] . Moreover, despite favorable intragastric pH control, patients with comorbid illnesses still have higher recurrent bleeding [10] .…”