THE MANAGEMENT OF PEPTIC-ULCER DISEASE IN THE 1990S

Perceptions regarding the effective management of peptic ulcer disease have changed dramatically over the past few years. Healing of the ulcer crater is no longer a problem and the real challenge of management is now the prevention of the almost inevitable ulcer relapse. While the pathogenetic model of acid-pepsin aggression versus mucosal resistance has provided a rationale for the use of either acid-inhibitory or mucosal-protective therapy for ulcer healing, peptic ulcers are now increasingly being seen as Helicobacter pylori-related (the majority), NSAID-related (an important minority) and, less commonly, purely 'acid-related'.(1) Acceptance of these aetiological factors now provides the basis for an effective short- and long-term management strategy for peptic ulcer disease.