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Helicobacter pylori-negative gastric ulcer. 1992

T J Borody, and S Brandl, and P Andrews, and E Jankiewicz, and N Ostapowicz
Centre for Digestive Diseases, Sydney, Australia.

Causes of Helicobacter pylori (HP)-negative gastric ulcers (GUs) have not previously been systematically studied. In this study we examined possible causes of HP-negative GUs. Among 115 consecutive patients with endoscopic diagnoses of GU, 71 (62%) had HP infection, and 44 (38%) were found to be HP-negative. Of the 71 HP-positive patients, 47 (66%) had no other detectable causal factors, 21 (30%) were regularly taking nonsteroidal antiinflammatory drugs (NSAIDs), and three (4%) had malignant GU. Of the 44 HP-negative patients, 29 (66%) were taking NSAIDs, two (5%) had a malignant GU, whereas 13/44 (30%) (11% of total 115) patients had no identifiable cause. These patients were classified as having "idiopathic GU." Some 38/115 (33%) GUs occurred on the lesser curve, and these were more often (p = 0.012) HP-positive (76%) than prepyloric GUs (60/115 (52%)). We conclude that although most patients have an identifiable cause of GU, around 11% will have no apparent contributing factor. HP-positive GUs are more frequently located on the lesser curve. It is now important to identify the cause of GU, because this may dictate choice of management.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D005260 Female Females
D005753 Gastric Mucosa Lining of the STOMACH, consisting of an inner EPITHELIUM, a middle LAMINA PROPRIA, and an outer MUSCULARIS MUCOSAE. The surface cells produce MUCUS that protects the stomach from attack by digestive acid and enzymes. When the epithelium invaginates into the LAMINA PROPRIA at various region of the stomach (CARDIA; GASTRIC FUNDUS; and PYLORUS), different tubular gastric glands are formed. These glands consist of cells that secrete mucus, enzymes, HYDROCHLORIC ACID, or hormones. Cardiac Glands,Gastric Glands,Pyloric Glands,Cardiac Gland,Gastric Gland,Gastric Mucosas,Gland, Cardiac,Gland, Gastric,Gland, Pyloric,Glands, Cardiac,Glands, Gastric,Glands, Pyloric,Mucosa, Gastric,Mucosas, Gastric,Pyloric Gland
D005773 Gastroscopy Endoscopic examination, therapy or surgery of the interior of the stomach. Gastroscopic Surgical Procedures,Surgical Procedures, Gastroscopic,Gastroscopic Surgery,Surgery, Gastroscopic,Gastroscopic Surgeries,Gastroscopic Surgical Procedure,Gastroscopies,Procedure, Gastroscopic Surgical,Procedures, Gastroscopic Surgical,Surgeries, Gastroscopic,Surgical Procedure, Gastroscopic
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000894 Anti-Inflammatory Agents, Non-Steroidal Anti-inflammatory agents that are non-steroidal in nature. In addition to anti-inflammatory actions, they have analgesic, antipyretic, and platelet-inhibitory actions. They act by blocking the synthesis of prostaglandins by inhibiting cyclooxygenase, which converts arachidonic acid to cyclic endoperoxides, precursors of prostaglandins. Inhibition of prostaglandin synthesis accounts for their analgesic, antipyretic, and platelet-inhibitory actions; other mechanisms may contribute to their anti-inflammatory effects. Analgesics, Anti-Inflammatory,Aspirin-Like Agent,Aspirin-Like Agents,NSAID,Non-Steroidal Anti-Inflammatory Agent,Non-Steroidal Anti-Inflammatory Agents,Nonsteroidal Anti-Inflammatory Agent,Anti Inflammatory Agents, Nonsteroidal,Antiinflammatory Agents, Non Steroidal,Antiinflammatory Agents, Nonsteroidal,NSAIDs,Nonsteroidal Anti-Inflammatory Agents,Agent, Aspirin-Like,Agent, Non-Steroidal Anti-Inflammatory,Agent, Nonsteroidal Anti-Inflammatory,Anti-Inflammatory Agent, Non-Steroidal,Anti-Inflammatory Agent, Nonsteroidal,Anti-Inflammatory Analgesics,Aspirin Like Agent,Aspirin Like Agents,Non Steroidal Anti Inflammatory Agent,Non Steroidal Anti Inflammatory Agents,Nonsteroidal Anti Inflammatory Agent,Nonsteroidal Anti Inflammatory Agents,Nonsteroidal Antiinflammatory Agents
D013276 Stomach Ulcer Ulceration of the GASTRIC MUCOSA due to contact with GASTRIC JUICE. It is often associated with HELICOBACTER PYLORI infection or consumption of nonsteroidal anti-inflammatory drugs (NSAIDS). Gastric Ulcer,Gastric Ulcers,Stomach Ulcers,Ulcer, Gastric,Ulcer, Stomach,Ulcers, Gastric,Ulcers, Stomach
D016480 Helicobacter pylori A spiral bacterium active as a human gastric pathogen. It is a gram-negative, urease-positive, curved or slightly spiral organism initially isolated in 1982 from patients with lesions of gastritis or peptic ulcers in Western Australia. Helicobacter pylori was originally classified in the genus CAMPYLOBACTER, but RNA sequencing, cellular fatty acid profiles, growth patterns, and other taxonomic characteristics indicate that the micro-organism should be included in the genus HELICOBACTER. It has been officially transferred to Helicobacter gen. nov. (see Int J Syst Bacteriol 1989 Oct;39(4):297-405). Campylobacter pylori,Campylobacter pylori subsp. pylori,Campylobacter pyloridis,Helicobacter nemestrinae
D016481 Helicobacter Infections Infections with organisms of the genus HELICOBACTER, particularly, in humans, HELICOBACTER PYLORI. The clinical manifestations are focused in the stomach, usually the gastric mucosa and antrum, and the upper duodenum. This infection plays a major role in the pathogenesis of type B gastritis and peptic ulcer disease. Infections, Helicobacter,Helicobacter Infection,Infection, Helicobacter

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