https://scholars.lib.ntu.edu.tw/handle/123456789/545385
標題: | A systematic approach for the diagnosis and treatment of idiopathic peptic ulcers | 作者: | Chung C.-S. TSUNG-HSIEN CHIANG YI-CHIA LEE |
公開日期: | 2015 | 出版社: | Korean Association of Internal Medicine | 卷: | 30 | 期: | 5 | 起(迄)頁: | 559-570 | 來源出版物: | Korean Journal of Internal Medicine | 摘要: | An idiopathic peptic ulcer is defined as an ulcer with unknown cause or an ulcer that appears to arise spontaneously. The first step in treatment is to exclude common possible causes, including Helicobacter pylori infection, infection with other pathogens, ulcerogenic drugs, and uncommon diseases with upper gastrointestinal manifestations. When all known causes are excluded, a diagnosis of idiopathic peptic ulcer can be made. A patient whose peptic ulcer is idiopathic may have a higher risk for complicated ulcer disease, a poorer response to gastric acid suppressants, and a higher recurrence rate after treatment. Risk factors associated with this disease may include genetic predisposition, older age, chronic mesenteric ischemia, smoking, concomitant diseases, a higher American Society of Anesthesiologists score, and higher stress. Therefore, the diagnosis and management of emerging disease should systematically explore all known causes and treat underlying disease, while including regular endoscopic surveillance to confirm ulcer healing and the use of proton-pump inhibitors on a case-by-case basis. ? 2015 The Korean Association of Internal Medicine. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-84942111842&doi=10.3904%2fkjim.2015.30.5.559&partnerID=40&md5=06a3841099490f7409a232fe01590000 https://scholars.lib.ntu.edu.tw/handle/123456789/545385 |
ISSN: | 1226-3303 | DOI: | 10.3904/kjim.2015.30.5.559 | SDG/關鍵字: | acetylsalicylic acid; alendronic acid; antibiotic agent; bisphosphonic acid derivative; histamine H2 receptor antagonist; immunosuppressive agent; nonsteroid antiinflammatory agent; placebo; potassium chloride; prostaglandin; proton pump inhibitor; steroid; age; comorbidity; Crohn disease; diagnostic error; duodenum ulcer; endoscopy; false negative result; genetic predisposition; Helicobacter infection; human; idiopathic disease; idiopathic peptic ulcer; incidence; mental stress; mesenteric ischemia; peptic ulcer; peptic ulcer bleeding; prevalence; rapid urease test; recurrence risk; Review; smoking; stomach mucosa lesion; stomach ulcer; urea breath test; Zollinger Ellison syndrome; drug effects; gastrointestinal endoscopy; patient selection; peptic ulcer; predictive value; risk assessment; risk factor; treatment outcome; wound healing; Endoscopy, Gastrointestinal; Humans; Patient Selection; Peptic Ulcer; Predictive Value of Tests; Proton Pump Inhibitors; Risk Assessment; Risk Factors; Treatment Outcome; Wound Healing |
顯示於: | 醫學系 |
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