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Helicobacter pylori-negative duodenal ulcer.

Abstract

Most patients with chronic duodenal ulcer (DU) craters have gastritis associated with Helicobacter pylori (HP), now thought to be the major cause of DU. A smaller proportion of DU patients have no detectable HP. In this study, we examined the frequency and causes of HP-negative duodenal ulcers. In 302 consecutive patients with endoscopic diagnosis of duodenal ulcer, 284 (94%) were found to have associated HP gastritis, whereas 18 (6%) were HP-negative on histology, culture, and urease test. The largest subgroup of HP-negative patients (8/18) was made up of those who had been taking nonsteroidal antiinflammatory drugs (NSAIDs), followed closely (4/18) by patients with recent intake of antibiotics. Causes of DU in the remaining subgroups included two patients with duodenal Crohn's disease, two with Gastrospirillum hominis infection, one with penetrating carcinoma of the pancreas and one with no detectable cause. We conclude that, although the most common causal factor of duodenal ulcer is HP, some 6% of DU's will be HP-negative, signaling unusual etiology. It is now important to identify the cause of duodenal ulcer so as to initiate appropriate therapy.

Authors+Show Affiliations

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Centre for Digestive Diseases, Sydney, Australia.

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Source

MeSH

Adult
Aged
Aged, 80 and over
Anti-Bacterial Agents
Anti-Inflammatory Agents, Non-Steroidal
Crohn Disease
Duodenal Ulcer
Duodenitis
Female
Gram-Negative Bacteria
Helicobacter pylori
Humans
Male
Middle Aged
Pancreatic Neoplasms

Pub Type(s)

Journal Article

Language

eng

PubMed ID

1882793

Citation

Borody, T J., et al. "Helicobacter Pylori-negative Duodenal Ulcer." The American Journal of Gastroenterology, vol. 86, no. 9, 1991, pp. 1154-7.
Borody TJ, George LL, Brandl S, et al. Helicobacter pylori-negative duodenal ulcer. Am J Gastroenterol. 1991;86(9):1154-7.
Borody, T. J., George, L. L., Brandl, S., Andrews, P., Ostapowicz, N., Hyland, L., & Devine, M. (1991). Helicobacter pylori-negative duodenal ulcer. The American Journal of Gastroenterology, 86(9), pp. 1154-7.
Borody TJ, et al. Helicobacter Pylori-negative Duodenal Ulcer. Am J Gastroenterol. 1991;86(9):1154-7. PubMed PMID: 1882793.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Helicobacter pylori-negative duodenal ulcer. AU - Borody,T J, AU - George,L L, AU - Brandl,S, AU - Andrews,P, AU - Ostapowicz,N, AU - Hyland,L, AU - Devine,M, PY - 1991/9/1/pubmed PY - 1991/9/1/medline PY - 1991/9/1/entrez SP - 1154 EP - 7 JF - The American journal of gastroenterology JO - Am. J. Gastroenterol. VL - 86 IS - 9 N2 - Most patients with chronic duodenal ulcer (DU) craters have gastritis associated with Helicobacter pylori (HP), now thought to be the major cause of DU. A smaller proportion of DU patients have no detectable HP. In this study, we examined the frequency and causes of HP-negative duodenal ulcers. In 302 consecutive patients with endoscopic diagnosis of duodenal ulcer, 284 (94%) were found to have associated HP gastritis, whereas 18 (6%) were HP-negative on histology, culture, and urease test. The largest subgroup of HP-negative patients (8/18) was made up of those who had been taking nonsteroidal antiinflammatory drugs (NSAIDs), followed closely (4/18) by patients with recent intake of antibiotics. Causes of DU in the remaining subgroups included two patients with duodenal Crohn's disease, two with Gastrospirillum hominis infection, one with penetrating carcinoma of the pancreas and one with no detectable cause. We conclude that, although the most common causal factor of duodenal ulcer is HP, some 6% of DU's will be HP-negative, signaling unusual etiology. It is now important to identify the cause of duodenal ulcer so as to initiate appropriate therapy. SN - 0002-9270 UR - https://www.unboundmedicine.com/medline/citation/1882793/full_citation DB - PRIME DP - Unbound Medicine ER -