Prognosis of medically treated gastric ulcer. A prospective endoscopic study.

During the study period 1972-74 gastric ulcer was demonstrated by endoscopy in 114 patients, 54 of whom were included in the present study. Forty-two were excluded because of ulcer showing incipient healing, superficial erosions, manifest or suspected malignancy, or indication for surgery. Eighteen patients were not included because of advanced age, complicating diseases, or refusal to have further examinations. The study comprises a treatment phase and a follow-up phase. The treatment phase ran from the first encoscopic demonstration of gastric ulcer until complete healing. During this period the patient was treated with antacids and anticholinergics and, if required by his condition, admission to hospital. During the treatment phase, endoscopy was performed at intervals of from 3 to 6 weeks until healing. During the follow-up phase endoscopy was carried out in the event of dyspeptic complaints that might indicate recurrent ulcer. The healing and recurrence rates for various periods were calculated by the aid of the life-table method. After 1 mo. of treatment 13% of the aptients exhibited healing, after 2 mo. 29%, after 3 mo. 41%, and after 12 mo. 79%. In one month 9% of the primarily healed ulcers had recurred, in 2 mo. 15%, in 3 mo. 22%, and in 12 mo. 43%. The healing rate is appreciably lower than results reported in the literature, whereas the recurrence rate is in closer accordance with previous studies.