| Theme |
How to Diagnose Gastric Diseases in Patients without Helicobacter pylori Infection |
| Title |
Gastric Erosions and Ulcers in H. pylori—negative Patients |
| Author |
Akiko Shiotani |
Division of Gastroenterology, Department of Internal Medicine, Kawasaki Medical School |
| Author |
Kyosuke Goda |
Division of Gastroenterology, Department of Internal Medicine, Kawasaki Medical School |
| Author |
Takahisa Murao |
Division of Gastroenterology, Department of Internal Medicine, Kawasaki Medical School |
| Author |
Minoru Fujita |
Division of Gastroenterology, Department of Internal Medicine, Kawasaki Medical School |
| Author |
Hiroshi Matsumoto |
Division of Gastroenterology, Department of Internal Medicine, Kawasaki Medical School |
| Author |
Tomoari Kamada |
Department of Health Care Medicine, Kawasaki Medical School |
| [ Summary ] |
Helicobacter pylor (H. pylori) infection and nonsteroidal anti‒inflammatory drugs (NSAIDs) are two major risk factors for peptic ulcers, and H. pylori‒negative gastric erosions and ulcers tended to be increasing according to the decline in prevalence of the H. pylori infection and induced atrophic gastritis and the progress of population aging. NSAIDs induce mucosal injury not only by inhibition of prostaglandins production, but also by direct mucosal injury under acidic conditions, which are dependent on gastric luminal pH. NSAIDs ulcers are characterized as multiple, shallow, irregular in shape, and mucosal redness and erosions are often detected with ulcers. Idiopathic peptic ulcers (IPUs) are reported to be more refractory and recurrent to the treatment than H. pylori‒positive ulcers, and the prognosis of IPUs is often poor. Old age, multiple underlying comorbid diseases, and psychological stress are risk factors for IPUs. Long term acid suppression therapy is usually required to treat IPUs. |