Peptic Ulcer Disease: Basic and Clinical Aspects

Despi te a slow decrease in the incidence of peptic ulcer in the Western world during the past decade, general practitioners, physicians, gastroenterologists, and surgeons deal with patients suffering from peptic ulcer and its complications almost daily. It has been estimated that some 10% of the population in the Western world becomes af­ flicted by peptic ulcer at least once and many of them have chronic relapsing disease. This lays a heavy burden on the amount of money which is spent in general health care. In recent years our understanding of peptic ulcer disease has in­ creased tremendously, but considerable gaps in our knowledge remain. Originally the increase in our knowledge has been stimulated by the development of fibre-optic endoscopy in the sixties, and later by the development of new surgical techniques and drugs in the seventies. New insights into the pathophysiology of the disease resulted from these developments and revived the scientific interest in peptic ulcer disease. However, the field remains complicated and the studies are be­ devilled by the large number of variables which can affect the results. In the symposium 'PEPTIC ULCER TODAY' we have attemp­ ted to bring together recent knowledge on basic and clinical aspects of peptic ulcer disease.

Inhalt

Session I.- 1. Introduction to the Symposium.- 2. The epidemiology of peptic ulcer.- 3. Regulation of acid secretion: receptors, antagonists and interactions.- 4. Aetiology of duodenal ulcer.- 5. Pyloric function and its role in the pathogenesis of gastric ulcer.- 6 Pathogenesis of gastric mucosal damage: Role of the 'mucus bicarbonate barrier'.- 7. Discussion I.- Session II.- 8. Problems in the medical management of peptic ulcer.- 9. 1976-1984: How should we use histamine H2-receptor antagonists.- 10. Omeprazol: A review of its pharmacological and clinical properties.- 11. Medical treatment of peptic ulcer with prostaglandins.- 12. Discussion 11.- Session III.- 13. Genetic aspects of peptic ulcer.- 14. The possibilities of surgical treatment of peptic ulcer.- 15. Discussion III.- 16. The surgical treatment of gastric ulcer.- 17. Long-term results of highly selective vagotomy for gastric and duodenal ulcer.- 18. Discussion IV.- Session IV.- 19. Morphological changes in the stomach remnant after partial gastrectomy.- 20. Postgastrectomy syndromes and their surgical management.- 21. The role of mucosal blood flow in the pathogenesis and healing of peptic ulcer.- 22. Duodenal ulcers produced in rats by indomethacin plus bile duct ligation.- 23. Cytoprotection and adapted cytoprotection.- 24. Discussion V.- 25. The management of severe haemorrhage.- 26. Discussion VI.- 27. Management of recurrent duodenal ulcer after highly selective vagotomy, as seen by the physician.- 28. Management of recurrent duodenal ulcer after histamine H2-receptor antagonists and highly selective vagotomy.- 29. A national inquiry into the diagnosis and treatment of peptic ulcers by Dutch physicians and gastroenterologists in 1984.- 30. Results of a national inquiry among Dutch surgeons on the present treatment of peptic ulcer.- 31. Discussion VII.