Noriyuki Nakajima, Toshihisa Takeuchi, Ryota Hokari, Kazuyuki Narimatsu, Katsunori Iijima, Shigeto Koizumi, Kunio Kasugai, Masahide Ebi, Akihito Nagahara, Tsutomu Takeda, Toshihiko Tomita, Shinichiro Shinzaki, Kazuhiro Mizukami, Kazunari Murakami, Nobuaki Yagi, Rieko Mukai, Toshikatsu Okumura, Hiroki Tanabe, Kazuyuki Tanaka, Junichi Iwamoto, Atsushi Irisawa, Koh Fukushi, Hiromi Kataoka, Hirotada Nishie, Yasuhiro Fujiwara, Koji Otani, Osamu Handa, Yasuhiko Maruyama, Toshio Uraoka, Hiroko Hosaka, Takahisa Furuta, Tomohisa Takagi, Masakatsu Nakamura, Yuya Nyumura, Akitoshi Hakoda, Noriaki Sugawara, Taro Iwatubo, Kazuhiro Ota, Shinpei Kawaguchi, Kazuhide Higuchi, Hiroki Nishikawa
Journal of clinical biochemistry and nutrition 74(1) 82-89 2024年1月
This study investigated the trends in idiopathic peptic ulcers, examined the characteristics of refractory idiopathic peptic ulcer, and identified the optimal treatment. The characteristics of 309 patients with idiopathic peptic ulcer were examined. We allocated idiopathic peptic ulcers that did not heal after 8 weeks' treatment (6 weeks for duodenal ulcers) to the refractory group and those that healed within this period to the healed group. The typical risk factors for idiopathic peptic ulcer (atherosclerosis-related underlying disease or liver cirrhosis complications) were absent in 46.6% of patients. Absence of gastric mucosal atrophy (refractory group: 51.4%, healed group: 28.4%; p = 0.016), and gastric fundic gland polyps (refractory group: 17.6%, healed group: 5.9%; p = 0.045) were significantly more common in the refractory group compared to the healed group. A history of H. pylori eradication (refractory group: 85.3%, healed group: 66.0%; p = 0.016), previous H. pylori infection (i.e., gastric mucosal atrophy or history of H. pylori eradication) (refractory group: 48.5%, healed group: 80.0%; p = 0.001), and potassium-competitive acid blocker treatment (refractory group: 28.6%, healed group, 64.1%; p = 0.001) were significantly more frequent in the healed group compared to the refractory group. Thus, acid hypersecretion may be a major factor underlying the refractoriness of idiopathic peptic ulcer.