Current Concepts in Diagnosis and Management of Peptic Ulcer

Peptic ulcer disease had a tremendous effect on morbidity and mortality until the last decades of the 20th century, when epidemiological trends started to point to an impressive fall in its incidence. Two important developments are associated with the decrease in rates of peptic ulcer disease: the discovery of effective and potent acid suppressants and of Helicobacter pylori. With the discovery of H. pylori infection, the causes, pathogenesis, and treatment of peptic ulcer disease have been rewritten. The inhibition of gastric acid secretion is a key therapeutic target for the ulcer diseases (viz., peptic, duodenal ulcers or that through H. pylori infection), gastro esophageal reflux disease (GERD), Zollinger–Ellison syndrome (Z-E), and gastritis. Currently this is achieved by blocking the acid secretary effect of histamine (HA) through the use of H2-receptor antagonists or the irreversible H+/K+-ATPase inhibitors, popularly referred to as proton pump inhibitors (PPIs). The incidence of ulcer diseases shows global variation and their treatment should be designed to alleviate the symptoms. Key words: Peptic ulcer, Helicobacter pylori, Zollinger–Ellison syndrome