Endoscopy 2003; 35(1): 9-14
DOI: 10.1055/s-2003-36397
State of the Art Review
© Georg Thieme Verlag Stuttgart · New York

Ulcers and Gastritis

H.  Kashiwagi1
  • 1Dept. of Surgery, Kashiwa Hospital, Jikei University School of Medicine, Chiba, Japan
Further Information

Publication History

Publication Date:
02 January 2003 (online)

This article reviews recently published literature regarding ulcers and gastritis. Although endoscopy is the most useful procedure for diagnosis in the upper gastrointestinal tract, complications do occur, and procedure-related costs are significant. The appropriate indication for endoscopy has recently been debated. Helicobacter pylori is known to be an important pathogen involved in gastric and duodenal inflammation. Peptic ulcer disease and severe gastric mucosal injury are caused by virulent strains, and many reports have focused on CagA. Follow-up studies on surveillance endoscopy in patients with peptic ulcer or gastritis report that patients with atrophic gastritis and intestinal metaplasia are at significantly higher risk for gastric cancer. H. pylori eradication sometimes causes gastroduodenal erosion and reflux esophagitis, and the mechanisms involved have been revealed. Proton-pump inhibitors are useful in the treatment of ulcers caused by nonsteroidal anti-inflammatory drugs (NSAIDs), reflux esophagitis, and for preventing rebleeding after endoscopic hemostasis, but the effect of long-term acid suppression on the gastric mucosa is still a matter of debate. H. pylori infection and NSAID intake are both risk factors for peptic ulcer disease, and are important aspects in this field.

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H. Kashiwagi, M.D., Ph.D.

Dept. of Surgery, Kashiwa Hospital, Jikei University School of Medicine

163-1 Kashiwa-shita · Chiba, 277-8567 · Japan

Fax: + 81-4-7166-9374

Email: hkashiwagi.surg@jikei.ac.jp

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