THE YALE JOURNAL OF BIOLOGY AND MEDICINE 65 (1992), 689-692 Current Clinical Management of Peptic Ulcer Disease

The papers presented in this section highlight some of the recent advances in understanding the pathogenesis of peptic ulcer disease, its therapeutics through control of acid secretion, and the implications of hypergastrinemia produced by perturbations in the feedback loop controlling the release of gastrin from the antral G cell. Each paper simultaneously illustrates the sophistication of our knowledge and, in counterpoint, our ignorance. While the application of 20 leeches to the anus as described by Cruveilhier in the seventeenth century has fallen out of favor as accepted ulcer therapy, the choice of a therapeutic agent is still controversial. Illustrative of these issues is the role of Helicobacterpylori in the pathogenesis of peptic ulcer and its relapse and the potential therapeutic implications of its eradica-tion. This organism, reported in the late 1800s as a urea-producing gastric bacterium and rediscovered by Warren [1] and Marshall [2,3] has had a significant effect on our understanding of the pathogenesis of type B gastritis, peptic ulcer and its relapse, and putatively on the etiology of gastric adenocarcinoma. Ingestion of the organism has been shown to lead to acute gastritis, and eradication of the organism wit