Management of Peptic Ulcer Disease

Abstract

Peptic ulcer disease (PUD) is an important cause of the complex of symptoms known as dyspepsia. Although it can only be found in up to 5% of all upper GI endoscopies performed for investigation of dyspepsia, it can be associated with different complications with the potential for significant morbidity and mortality, such as recurrence, bleeding, perforation, and GI obstruction [1, 2]. The annual incidence rate of peptic ulcer ranges from 0.1% to 0.3% worldwide, but the prevalence of PUD, hospitalization, and surgery rates for uncomplicated ulcers have been in decline in the past few decades [3--6]. These facts are attributed to the better understanding of PUD multifactorial etiology [Helicobacter pylori (H. pylori) infection, nonsteroidal anti-inflammatory drugs (NSAIDs) use and smoking], change in environmental factors (improved food transportation and refrigeration, improved hygiene, socioeconomic conditions, and overall health), and powerful treatment options (antisecretory and antimicrobial drugs) [2, 7]. Peptic ulcers have a variable natural history; they can heal spontaneously but can also have a high recurrence rate ranging between 50% and 80% annually. On the other hand, some can cause complications or remain refractory, despite the antisecretory therapy [8--11].