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What Are Refractory Peptic Ulcers and Why Do They Persist?
Published: Mar 22, 2024
Refractory peptic ulcers are stubborn sores in the stomach lining that refuse to heal with typical treatments. Discover why these ulcers persist and how they can be effectively managed.
Understanding Refractory Ulcers
Refractory peptic ulcers are defined as ulcers that do not heal after 8 to 12 weeks of treatment with acid-reducing medications. These ulcers are often larger than 5 mm in diameter and can persist even with continued treatment. Refractory ulcers are a challenge because they remain even after typical interventions, requiring a deeper look into underlying causes.
Common Causes and Risk Factors
Persistent Helicobacter pylori infection and the use of nonsteroidal anti-inflammatory drugs (NSAIDs) are major culprits of refractory ulcers. Sometimes, antibiotics may fail due to resistance or improper regimen selection. Other risk factors include smoking, certain medications, and underlying diseases like Crohn's disease or Zollinger-Ellison syndrome.
Diagnosis and Identification
Refractory ulcers are suspected in patients with ongoing stomach pain or discomfort despite treatment. Diagnosis is confirmed through upper endoscopy, which allows doctors to take tissue samples and rule out other conditions. Identifying the exact cause is crucial for tailoring the treatment to effectively manage the ulcer.
Frequently Asked Questions
It's an ulcer that doesn't heal after 8-12 weeks of treatment.
Persistent infections or continued NSAID use can prevent healing.
Through endoscopy and tissue sampling.
Yes, smoking can impair the healing process.
Wrapping Up
Understanding and addressing the root causes of refractory ulcers is vital for effective treatment and healing.
References
- Hopkins RJ, Girardi LS, Turney EA. Gastroenterology 1996; 110:1244.
- Laine L, Hopkins RJ, Girardi LS. Am J Gastroenterol 1998; 93:1409.
This article has been reviewed for accuracy by one of the licensed medical doctors working for Doctronic. Always discuss health information with your healthcare provider.
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