The Treatment of Peptic Ulcer

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“RECENT measures advocated for the treatment of peptic ulcer range from pituitary ‘snuff’ to fresh cabbage juice! To these can be added mucin, you.” This quotation is from an article by George B. Eusterman in the 1949 Year Book of Medicine. The number of treatments for peptic ulcer are indeed unlimited.

Although each patient presents an individual problem, all clinicians are agreed that first attention should be given to the patient’s general health, including his hygienic needs such as living habits, physical and mental rest, and proper nutrition.

The methods employed in treating peptic ulcer at Cleveland Clinic depend primarily upon the location of the ulcer. Analysis of our records show that 85 per cent of patients having duodenal ulcers make satisfactory progress on medical management alone. Most of the other 15 per cent, having intractable duodenal ulcers and/or complications, have been benefited by bilateral vagus resections plus gastroenterostomy. Gastric resection is being employed in most patients having gastric ulcer.

This discussion is divided into three parts: first, gastric ulcer and the complications of peptic ulcer in general; second, the medical management in patients having uncomplicated duodenal ulcers, and finally, a 2 year follow-up study of our first 100 consecutive patients with complicated duodenal ulcers who have had bilateral vagotomies plus gastroenterostomy or pyloroplasty. During the past 4 years 495 patients have had bilateral vagotomies.

Part I

Gastric Ulcer

When an ulcerating carcinoma of the stomach is demonstrated by roentgen and/or gastroscopic examination, gastric resection obviously is indicated. However, the. . .



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