Intractable Gastric Ulcer, Report of a Case Kiyoshi Ashida 1 , Masahiro Sakaguchi 1 , Naofumi Osaka 1 , Masaya Tanaka 1 , Saburo Ohshiba 1 1The Second Department of Internal Medicine, Osaka Medical College Keyword: 難治性胃潰瘍 , 胃内pHモニタリング , 胃液酸度 , H2ブロッカー , PPI pp.339-344
Published Date 1993/3/25
DOI https://doi.org/10.11477/mf.1403106124
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 A 44-year-old male patient, who had been under treatment for duodenal ulcer at our clinic since 1983, complained in 1989 of a stubborn epigastric pain of one year duration, after a two-year absence from treatment (1987-1988). Endoscopic examination revealed an active ulcer in the lesser curvature of the gastric angle.

 H2-blocker treatment was carried out for as long as 14 weeks, with favorable results. The disease subsequently recurred, however, and was treated with proton pump inhibitor (PPI), which took effect promptly. Intragastric pH monitoring showed that the gastric juice acidity was fully controlled by PPI all day long, whereas it was not reduced by H2-blocker in the daytime. The higher therapeutic effect of PPI seems to be due to its action in reducing gastric acidity. Unfortunately, the cessation of PPI administration resulted in relapse of the disease. A new concurrent therapy is therefore needed, to prevent recurrence.

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