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. 1981 Feb;22(2):97–102. doi: 10.1136/gut.22.2.97

Factors affecting the healing rate of duodenal and pyloric ulcers with low-dose antacid treatment.

S Massarrat, A Eisenmann
PMCID: PMC1419232  PMID: 7215949

Abstract

In 80 patients with duodenal ulcer, the effects of various factors--symptoms, endoscopic findings, and peak acid output (PAO)--on the healing rate were studied during eight weeks of outpatient therapy with low-dose antacid (neutralising capacity less than 50 mmol HCl/d). Fifty-six per cent of the ulcers healed. The following unfavourable factors were found to cause a significant delay in ulcer healing: a long duration of pain in the last ulcer relapse and the present period of ulcer pain, smoking, stenosis of the duodenal bulb, and a high PAO. Multiple regression analysis showed that three factors (duration of the present ulcer pain, smoking, and stenosis of the duodenum) had a significant influence on healing rate. According to the results obtained with this method, the patients with no or only one unfavourable factor (n = 35) had the best healing rate: 80%, compared with patients who had two (n = 31) or three (n = 14) unfavourable factors. The healing rate of the latter two groups was 41% and 28%, respectively (p less than 0.001). A prognostic score based on these three factors represents the severity of duodenal-ulcer disease with regard to the healing process under placebo-like doses of antacid.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bank S., Barbezat G. O., Novis B. H., Tim L. O., Odes H. S., Helman C., Narunsky L., Duys P. J., Marks I. N. Histamine H2-receptor antagonists in the treatment of duodenal ulcers. S Afr Med J. 1976 Oct 16;50(44):1781–1785. [PubMed] [Google Scholar]
  2. Best W. R., Becktel J. M., Singleton J. W., Kern F., Jr Development of a Crohn's disease activity index. National Cooperative Crohn's Disease Study. Gastroenterology. 1976 Mar;70(3):439–444. [PubMed] [Google Scholar]
  3. Binder H. J., Cocco A., Crossley R. J., Finkelstein W., Font R., Friedman G., Groarke J., Hughes W., Johnson A. F., McGuigan J. E. Cimetidine in the treatment of duodenal ulcer: a multicenter double blind study. Gastroenterology. 1978 Feb;74(2 Pt 2):380–388. [PubMed] [Google Scholar]
  4. Blackwood W. S., Maudgal D. P., Pickard R. G., Lawrence D., Northfield T. C. Cimetidine in duodenal ulcer. Controlled trial. Lancet. 1976 Jul 24;2(7978):174–176. doi: 10.1016/s0140-6736(76)92347-3. [DOI] [PubMed] [Google Scholar]
  5. Blum A. L., Siewert J. R., Halter F. Ulkustherapie mit Cimetidin. Dtsch Med Wochenschr. 1978 Jan 27;103(4):135–139. doi: 10.1055/s-0028-1104394. [DOI] [PubMed] [Google Scholar]
  6. Bodemar G., Walan A. Cimetidine in the treatment of active duodenal and prepyloric ulcers. Lancet. 1976 Jul 24;2(7978):161–164. doi: 10.1016/s0140-6736(76)92342-4. [DOI] [PubMed] [Google Scholar]
  7. Giger M., Gonvers J. J., Weber K. B., Sonnenberg A., Birchler R., Mattle W., Hofstetter J. R., Blum A. L. Therapie des Ulcus duodeni mit Cimetidin, Pirenzepin und Placebo: Bericht über eine doppeltblinde, randomisierte Studie. Schweiz Med Wochenschr. 1979 Apr 21;109(16):617–618. [PubMed] [Google Scholar]
  8. Hetzel D. J., Hansky P. J., Shearman D. J., Korman M. G., Hecker R., Taggart G. J., Jackson R., Gabb B. W. Cimetidine treatment of duodenal ulceration: short term clinical trial and maintenance study. Gastroenterology. 1978 Feb;74(2 Pt 2):389–392. [PubMed] [Google Scholar]
  9. Hollander D., Harlan J. Antacids vs placebos in peptic ulcer therapy. A controlled double-blind investigation. JAMA. 1973 Dec 3;226(10):1181–1185. [PubMed] [Google Scholar]
  10. Ippoliti A. F., Sturdevant R. A., Isenberg J. I., Binder M., Camacho R., Cano R., Cooney C., Kline M. M., Koretz R. L., Meyer J. H. Cimetidine versus intensive antacid therapy for duodenal ulcer: a multicenter trial. Gastroenterology. 1978 Feb;74(2 Pt 2):393–395. [PubMed] [Google Scholar]
  11. Lam S. K., Lam K. C., Lai C. L., Yeung C. K., Yam L. Y., Wong W. S. Treatment of duodenal ulcer with antacid and sulpiride. A double-blind controlled study. Gastroenterology. 1979 Feb;76(2):315–322. [PubMed] [Google Scholar]
  12. Lambert R., Bader J. P., Bernier J. J., Bertrand J., Bétourné C., Gastard J., Laverdant C., Ribet A., Sahel J., Toulet J. Traitement de l'ulcère gastrique et duodénal par la cimétidine. Etude multicentrique. Gastroenterol Clin Biol. 1977;1(11):855–860. [PubMed] [Google Scholar]
  13. Nakajima T. Studies on factors affecting healing of gastric ulcer. A prospective, cooperative study in Japan. Am J Gastroenterol. 1976 Aug;66(2):150–154. [PubMed] [Google Scholar]
  14. Peter P., Kiene K., Gonvers J. J., Pelloni S., Weber K., Sonnenberg A., Schmitz H., Richter O., Hofstetter J. R., Blum A. L. Cimetidin in der Behandlung des Ulcus duodeni. Ergebnisse einer Doppelblindstudie bei ambulant behandelten Patienten. Dtsch Med Wochenschr. 1978 Jul 21;103(29):1163–1166. doi: 10.1055/s-0028-1129221. [DOI] [PubMed] [Google Scholar]
  15. Peterson W. L., Sturdevant R. A., Frankl H. D., Richardson C. T., Isenberg J. I., Elashoff J. D., Sones J. Q., Gross R. A., McCallum R. W., Fordtran J. S. Healing of duodenal ulcer with an antacid regimen. N Engl J Med. 1977 Aug 18;297(7):341–345. doi: 10.1056/NEJM197708182970701. [DOI] [PubMed] [Google Scholar]
  16. Scheurer U., Witzel L., Halter F., Keller H. M., Huber R., Galeazzi R. Gastric and duodenal ulcer healing under placebo treatment. Gastroenterology. 1977 May;72(5 Pt 1):838–841. [PubMed] [Google Scholar]
  17. Sun D. C., Stempien S. J. The Veterans Administration Cooperative Study on Gastric Ulcer. 3. Site and size of the ulcer as determinants of outcome. Gastroenterology. 1971 Oct;61(4 Suppl):576–584. [PubMed] [Google Scholar]
  18. Winship D. H. Cimetidine in the treatment of duodenal ulcer: review and commentary. Gastroenterology. 1978 Feb;74(2 Pt 2):402–406. [PubMed] [Google Scholar]

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