Prostaglandins in peptic ulcer disease. Their postulated role in the pathogenesis and treatment.

Prostaglandins are important in the pathophysiology of peptic ulcer disease and possibly in its prevention and treatment as well. Prostaglandins have been shown to inhibit gastric secretion, stimulate bicarbonate secretion, and increase gastric blood volume. Pretreatment with prostaglandins has recently been found to promote rapid restitution of the superficial epithelium of the gastric mucosa and preservation of the deeper layers. These effects and their degree of importance to an individual patient may depend on the insulting agent. Orally administered prostaglandin analogues have been helpful in some patients who failed to heal with standard ulcer treatment and in smokers, who usually do not heal as well as nonsmokers. They have also been effective in persons at high risk for gastric lesions, such as chronic consumers of nonsteroidal antiinflammatory drugs or alcohol. Recent reports show that persons with peptic ulcer disease may produce fewer prostanoids than others, so replacement therapy may be useful in preventing damage of the gastroduodenal mucosa.