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May 1990

Campylobacter (Helicobacter) pylori: Is Peptic Disease a Bacterial Infection?

Author Affiliations

USA Gastroenterology Service Walter Reed Army Medical Center Washington, DC 20307-5001

Arch Intern Med. 1990;150(5):951-955. doi:10.1001/archinte.1990.00390170013004

Despite extensive investigation, the cause of peptic ulcer disease remains unknown. It is generally accepted that peptic ulcers result from an imbalance between aggressive factors and innate mucosal protective mechanisms. Much attention over the last 30 years has been directed at the role of acid in the generation of peptic ulceration. Suppression of acid production with the histamine 2 (H2)—receptor antagonists is a highly effective means of healing acute ulcers. Ulcer recurrence rates as high as 90% in the first year, however, are a testament to the fact that the underlying pathophysiological mechanisms of ulcerogenesis are unaltered. Although we can heal the ulcers, we cannot cure the disease. This fact has prompted intense ongoing investigation into the whole issue of ulcer pathogenesis, and investigators are paying increasing attention to factors that might weaken the defenses of the gastric and duodenal epithelium. In the last 7 years, attention has

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