Peptic ulcer rebel

The majority of peptic ulcers heal by the administration of anti-H2 drugs or inhibitors of the proton pump in a month or two usually.

However, 5-10% of these ulcers do not heal in this time and do not heal if treatment is continued for several months.

Factors of resistance to treatment are:
1) a Helicobacter pylori infection.
So we must begin by eradicating Helicobacter pylori, when found, by antibiotic treatment being followed.
2) The non-steroidal anti-inflammatory drugs improperly,
3) a smoking
4) an inadequate response to antisecretory drugs
5) the abuse of aspirin.

These rebels ulcers are often multiple, changing location, sometimes very large.

They tend to be complicated, at the forefront of these possible complications must include haemorrhage and stenosis (narrowing).

Even high doses of inhibitors of proton pump fail to cure these ulcers.

Ulcers due solely to the presence of helicobacter pylori cure after eradication of the organism.

Ulcers due to the abuse of non-steroidal anti-inflammatory drugs do not heal after the termination of this abuse.

Note that the surgery should not be performed for these ulcers due to abuse of anti-inflammatory drugs because recurrence is almost inevitable and even more difficult to treat.

Surgery should be reserved in case of serious complications involving life-threatening, but knowing that the anti-inflammatory drugs nonsteroidal thereafter be prohibited.