Approaches to the long-term treatment of duodenal ulcer disease.

Determining a course of long-term management for the patient with peptic ulcer disease requires an assessment of the severity of the disease, prior ulcer history (including complications, therapeutic intervention, and response to treatment), the predictors of the disease course, the degree of disability, and the available therapy (pharmacologic or surgical). A consideration of the predictors of the disease course that have been previously identified as useful in ulcer clinical trials (sex, age, acid secretory response, serum pepsinogen concentration, cigarette usage) and of ulcer-related disability (nutritional, emotional, job status) provides objective criteria to be entered into the long-term management decision.