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Chang: Non-Helicobacter pylori, Non-nonsteroidal Anti-inflammatory Drug Peptic Ulcer Disease
Review Article

Korean J Gastroenterol 2016;67(6):313-317.

Published online: 4 October 2016

DOI: https://doi.org/10.4166/kjg.2016.67.6.313

Non-Helicobacter pylori, Non-nonsteroidal Anti-inflammatory Drug Peptic Ulcer Disease

Young Woon Chang

Department of Internal Medicine, Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul, Korea

Correspondence to: Young Woon Chang, Department of Internal Medicine, Kyung Hee University Hospital, Kyung Hee University College of Medicine, 23 Kyungheedae- ro, Dongdaemun-gu, Seoul 02447, Korea. Tel: +82-2-958-8200, Fax: +82-2-958-8150, E-mail: cywgi@chol.com

Copyright © 2016 Korean Ophthalmological Society

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Non-Helicobacter pylori, non-NSAID peptic ulcer disease (PUD), termed idiopathic PUD, is increasing in Korea. Diagnosis is based on exclusion of common causes such as H. pylori infection, infection with other pathogens, surreptitious ulcerogenic drugs, malignancy, and uncommon systemic diseases with upper gastrointestinal manifestations. The clinical course of idiopathic PUD is delayed ulcer healing, higher recurrence, higher re-bleeding after initial ulcer healing, and higher mortality than the other types of PUD. Genetic predisposition, older age, chronic mesenteric ischemia, cigarette smoking, concomitant systemic diseases, and psychological stress are considered risk factors for idiopathic PUD. Diagnosis of idiopathic PUD should systematically explore all possible causes. Management of this disease is to treat un¬derlying disease followed by regular endoscopic surveillance to confirm ulcer healing. Continuous proton pump inhibitor therapy is an option for patients who respond poorly to the standard ulcer regimen.

Keywords: Non-Helicobacter pylori, Non-nonsteroidal anti-inflammatory agents, Idiopathic peptic ulcer, Proton pump inhibitors

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